Southern Peigan Health Center

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Call Today!

406-338-7912
406-338-2491 fax
A walk in and primary care clinic, the Southern Peigan Health Center strives to provide the highest standards of clinical excellence.
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WHAT YOU WILL NEED:
 SPHC Patient Registration Form
 Medical Records Request & Release Form
 Consent to Treat Form
 Privacy of Practice Form​

PATIENT

Southern Peigan Health Center

SPHC FORMS​​

SPHC Patient Registration Form
Oki! Welcome to our Patient page. Here we offer a list of registration forms at a click of a button, you can download these applications or submit the form via email. Please read our Privacy Practice Policy form before hand. It is important that you sign and date all forms in order to be a registered patient with the Southern Peigan Health Center. If you have any questions or concerns, you can either contact us through our SPHC email or give us a call.


Thank You!
SPHC Staff
Medical Records Request and Release Form
Consent To Treat Form
Privacy of Practice Form
Medicaid Application
Medicaid Income Level Guideline
Notice of Privacy Practices
Contact Us!
If you have any questions, please do not hesitate to send us a message. We aim to reply within 24 hours.
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