Northwest Family Medicine

Coeur d'Alene

315 W Dalton Ave, Suite B
Coeur d'Alene, ID 83815

(208) 209-2066 | Phone
(208) 209-2076 | Fax

BECOME A PATIENT

Please find the form you need below, complete, and return to Northwest Family Medicine. If you’re having trouble finding the correct form, call us at (208) 262-2213 and we’ll help you find the right one.

New Patient Request Form

Notice of Physician Ownership

Notice of Physician Staffing and Emergency Procedures

Consent and Conditions of Treatment

Release of Information

HIPPA Release