(208) 667-4557

 

920 Ironwood Drive, Suite 101 / Coeur d'Alene / Idaho 83814

     
 
 
 
 

Ironwood Family Practice

Ironwood Family Practice required patients to fill out certain forms so we can provide the best possible for you and your family. Below is a list of forms for you to view and print. By filling out the necessary paperwork prior to your appointment, you will save the time during the check-in process and allow more time with our clinical team.

`

New Patient Registration

Medical History

Notice of Privacy Information Practices

Request For Release of Medical Records FROM Ironwood Family Practice

Request For Release of Medical Records TO Ironwood Family Practice

Sports Physical

Vasectomy Consent

Consent to Treat a Minor

Consent by Proxy for Non-Urgent Pediatric Care Form

New Patient Registration

 
 

Medical History

 

Notice of Privacy Information Practices

 
 

Request For Release of Medical Records FROM Ironwood Family Practice

 

Request For Release of Medical Records TO Ironwood Family Practice

 

Sports Physical

 

Vasectomy Consent

 

Consent to Treat a Minor

 

Consent by Proxy for Non-Urgent
Pediatric Care Form

 
 
 

Ironwood Family Practice
920 Ironwood Drive
Suite 101
Coeur d'Alene, ID 83814
PH: (208) 667-4557
FAX: (208) 765-2887

Ironwood Family Practice has been a place I have taken my kids for five years since moving from California. We have had nothing but great experience with the friendly staff and doctors.

- Lisa S.
Hayden, Idaho

 

I really appreciate your early morning hours. It makes it convenient for me being that I work and it makes it difficult to do anything after a long day.

- Cynthia R.
Coeur d'Alene, Idaho

 

 
 

PH: (208) 667-4557
FAX: (208) 765-2887
920 Ironwood Drive
Suite 101
Coeur d'Alene, ID 83814

 

Home | Our Providers | Services | Patient Forms
Policies and Procedures | Insurance | Pay Online | Patient Portal | Contact

All rights reserved | © Copyright 2017
Designed and developed by Knock - Marketing and Design

Ironwood Family Practice complies with applicable Federal civil rights laws and does not
discriminate on the basis of race, color, national origin, age, disability, or sex. Click here to view our Notice of Nondiscrimination.