If this is an appointment for a new patient, consent forms must be signed at the appointment by a parent or legal guardian. We will ask to see a current insurance card and the parent's or legal guardian's driver's license at the time of the appointment.
If this is not your first appointment with our office, the consent forms may have expired. Documents scanned into your child's medical chart are valid for one (1) year. In order to prevent any interruptions in your child's care, we may ask that updated consent forms to be signed at the appointment by a parent or legal guardian. We will also ask to see a current insurance card.
Please note: Each child is required to have their own set of signed consent forms and documents.
If the necessary consent forms cannot be signed by a parent or legal guardian at the time of the appointment, we will reschedule your child's appointment. This is important to keep in mind if a family member (other than a parent or legal guardian) or a friend will be bringing your child to the appointment.
Are you a foster parent?
Please bring the “Responsible Party for Medical Expenses and Consent for Treatment” letter provided by the Idaho Department of Health & Welfare to the appointment.
Online Consent to Treat Form:
Please note: If you (the parent or legal guardian) are unable to accompany your child to his/her appointment with our office, please complete our convenient "Consent to Treat" form ahead of your child's appointment.
With your written permission we can see your child, providing seamless care with the convenience busy parents appreciate.
Please complete the "Consent to Treat" form below and click submit.
(A PDF of the form will be emailed to you for your signature)
Is someone other than a parent or legal guardian bringing your child to the appointment?
If so, please follow these easy step by step instructions.
1. From your computer or phone, complete ALL information fields on the form below.
2. Press submit.
3. Your completed form will be emailed to you.
4. Print the form from your email.
5. Sign the completed form (electronic signatures cannnot be accepted).
6. Attach a copy of your driver's license and copies of any medical and vision insurance cards.
Your complete consent packet can be:
Given to the adult bringing your child to the appointment and provided to our office at check-in
Faxed to our office 24 HOURS BEFORE your child's appointment. Our fax number is 208.639.0329
Emailed to our office 24 HOURS BEFORE your child's appointment. Our email address is: email@example.com