We would like to make your visit to our offices as quick and efficient as possible. We will bill all insurances on your behalf. To do so, we need accurate information about birthdays, Social Security Numbers, Insurance Policies. We also need to know if this visit should be billed to a different insurance policy from your usual company. We are frequently asking you to update this information. We know this is inconvenient, but it is even more inconvenient to repeatedly rebill your insurance because this information is incorrect. To help streamline this process, we have placed our registration forms on line. They are available as Standard Web documents (html files) WordPerfect files and Microsoft Word files. There are multiple forms One for each Clinic Site in Helena HealthCare. We do intend to simplify this to one form, eventually.

We will also be posting other forms --> for example, Immunization Forms and Info.

 
Clinic        HTML WordPerfect Microsoft Word
Family Health Clinic FHC_Registration FHC_Registration FHC_Registration
Hawkins Lindstrom Clinic HLC_Registration HLC_Registration HLC_Registration
Internal Medicine Assoc IMA_Registration IMA_Registration IMA_Registration
Maria Dean Internal Med MDIM_Registration MDIM_Registration MDIM_Registration
MountainSide Internal Med MIM_Registration MIM_Registration MIM_Registration
Maria Dean Specialists MDS_Registration MDS_Registration MDS_Registration

 

Physician HTML WordPerfect Microsoft Word

Charles Anderson M.D.
Neurology

CA Registration CA Registration CA Registration
Mark Dietz M.D.
Neurology 		MD Registration MD Registration MD Registration
Jeffrey Dickerson M.D.
Pulmonology 		JD Registration JD Registration JD Registration
Ken Eden M.D.
Gastroenterology		 KE Registration KE Registration KE Registration
Arthur Snyder M.D.
Rheumatology 		AS Registration AS Registration AS Registration