Helpful guide to assist you in using Zoom on your
desktop computer or smart device.
All forms below are available for secure, electronic completion that meets HIPAA requirements. If you would prefer to print your forms for completion and bring them to your appointment, you can download them below.
Privacy Practices (English) Prácticas de privacidad (Español)Please select your form and then the clinic where you have scheduled an appointment.
Seleccione su formulario y luego la clínica donde ha programado una cita.
It is also helpful if you can fill out these forms ahead of time:
Consent to Treat Condiciones para Tratamiento New Patient Packet New Patient Health History Questionaire New Pediatric Patient Health History Questionaire Historia De Salud Historia De Salud Pediátrico Sliding Fee (Discount) Eligibility Elegibilidad de precios variables (Descuento)To apply for sliding fee discounts, fill out CHP’s Sliding Fee (Discount) Eligibility Form English (PDF), or Spanish (PDF). Include everyone in your household:
Bring this form AND documentation of your household income when you come for your visit.
Provide at least one proof of income for all working household members 18 years and older:
Below are the ways you can request your medical records from Community Health Partners. This will allow you to share them with another provider or to supplement insurance records.
My Chart
If you have questions or want to be sure you have prepared everything that is required to get the records that you are looking for, call 406.922.0840.
19 E. Main Street
Belgrade, MT, 59714
M - TH: 8:00 AM - 5:00 PM
Phone: 406.922.0840
Fax: 406.388.3461
If you have questions or want to be sure you have prepared everything that is required to get the records that you are looking for, call 406-922-0840.
Yes. CHP provides access to medical, behavioral health, and dental services for everyone. This includes people with limited incomes, no insurance, and all types of health insurance including high deductible and catastrophic-coverage-only plans. We also accept Medicaid, Healthy Montana Kids (HMK), and Medicare.
CHP provides care to everyone regardless of ability to pay. You may qualify for sliding fee discounts based on your family size and family income. Even if you have insurance coverage, sliding fee discounts can help with your deductible and co-pays.
If all members of your household are unemployed with no sources of income, or you are not able to provide proof of your income, we will follow up with a meeting or phone call to discuss how you may qualify for the discount.
Yes, we accept Medicaid, Medicare, Healthy Montana Kids (HMK), and private insurance and we will bill your insurance. Some plans common in Montana include:
These are just a few of the insurance carriers that we will bill for you.
If you are new to using Zoom we have put together a helpful guide to assist you in using Zoom on your desktop computer or smart device.