Resources and Links
Welcome to the InterMountain Medical Clinic Resources page. We know your time is valuable. To optimize your time with your provider it is helpful to have completed your intake forms. Below you’ll find digital handouts that you can easily reference at home or when you’re out and about. Download, print, then fill out and sign the documents below before your appointment.
Patient Forms
Click on the links below to access forms. Print the forms and fill them out before coming to our office.
Acknowledgement of Privacy Practices
New Clinic Patient Forms
New Patient Registration Form (all ages)
Child Medical History Form (less than 12 years old)
Osteoporosis Forms
DXA Wellness Screening Authorization
Other Forms
Patient Request for Health Information
Treadmill Stress Test Information
Sliding Fee Discount Application
To View these Forms and Documents you will need to have the Adobe Reader Application Installed.
You can install and download it from here.
To access or obtain a copy of your patient records, please download, complete and return this form to:
Attn: Privacy Officer
Phone: (208) 238 -1000
1951 Bench Rd, Suite B
Pocatello, ID 83201
Fax:(208) 238 -0009
We may charge you a reasonable fee for copies of your records. We will require payment before providing the copies. Please contact us if you would like to obtain an estimate of the cost of the copies in advance.