We are in the process of updating our forms and policies as we have moved to a new location. Please check back to see if any new forms have been posted! The following are forms and policies you may need when contacting our office. If you are new to our office you may want to print some of the forms out and bring them on your first visit.
General Practice Information
This form describes our office policies. We request that you are familiar with these policies.
This form will explain our financial policies.
Use this form to claim financial responsibility for a child or another adult.
Consent to Treat a Minor
Use this form to give your consent to treat a minor in the absence of a parent or guardian. This form is valid for 1 year, unless otherwise noted.
AACMT offers short term payment plans. This form is FOR REFERENCE of the payment plan terms ONLY. Payment plans must be set up in our office. Please contact our billing department (406-582-1111 Option 2) to discuss setting up a payment plan.
Medical Records Release
Use this form to request AACMT release your records to another person or healthcare provider.
Medical Records Request
Use this form to request forms from another provider or health organization be sent to AACMT.
This is a notice of our office’s privacy practices. Please contact the privacy officer with any questions at 406-582-1111×103.