Patient Forms
PATIENT RESOURCES
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical services and laboratory fees.
• Your health care provider must give you a Good Faith Estimate in writing for scheduled services in the designated timeframes. You can also ask your health care provider for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call Meridian Family Medicine at (208)888-1199.
Records Release Form
Patient Portal
Pre-Register as a New Patient or Log-In as an established patient:
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Patient Portal
Vaccine Information
Access Vaccine Information Statements (VIS) to learn more about recommended immunizations:
Meridian Family Medicine is currently accepting new patients under the age of 60.
Please prepare for your Appointment:
- Verify Insurance Eligibility - please contact your insurance to verify in-network status. See below for more information regarding insurances we no longer accept.
- Transfer your Medical Records - we recommend patient's contact your previous healthcare provider(s) to transfer their medical records. You may also complete our Records Request Form and return it to our office.
- Complete New Patient Forms - you may return paperwork to our office prior to your appointment or turn them in at the time of your visit.
- Arrive 15 Minutes Early - please check in 15 minutes early to allow more time.
- Minors - new patients under the age of 18 must arrive with a parent/legal guardian. Legal guardianship forms must be provided.
Meridian Family Medicine
1525 E Leighfield Dr, #150 Meridian, ID 83646
Phone: (208) 888-1199 Fax: (208) 888-0807
New Patient Information
Vaccine Policy Statement
Here at Meridian Family Medicine, we support childhood immunizations. We recognize the vital role vaccinations play in safeguarding the health of your children. Getting your child vaccinated not only helps protect your child, it also helps protect others in your community—like your friend who cannot get certain vaccines, or your neighbor’s new baby who is too young to be fully vaccinated. When everyone who can get vaccinated does get vaccinated, it helps to prevent the spread of disease within a community.
Our hope is to provide information and answer questions to help you make a good decision for you and your child. We strive to partner with you in your child’s care, without judgment and with sound reasoning.
Please approach any of our providers or clinical staff with questions you may have regarding immunizations. They want to help you make an informed and appropriate decision for your child. We have also provided a schedule of recommended immunizations based upon age. In a partnership with Idaho, we offer all recommended childhood immunizations in a safe, friendly environment.
Insurance Information
No Surprise Act Notice for Patients
Although our office takes most insurance plans, we recommend all patients contact their insurance to verify their in-network status.
Due to a variety of insurance plans, we do not check patient benefits and advise that patients are familiar with their plan coverage.
Not Accepting:
- Medicare Plans
- Adult Medicaid (ages 19+)
- First Health Network
- Tricare
- United HealthCare Select Plus-HSA
Dr. Butuk and his staff are very excited to be participating in clinical research trials for the advancement of new medications, medical devices and improving FDA approved medicines. To learn more about clinical research and see what types of clinical trials we are currently enrolling, click on the logo or go to our website.
To help improve your experience of care and better response times, we advise all patients sign up for our patient portal. New Patients can pre-register on the patient portal.
The patient portal offers features such as:
- Message your healthcare provider
- View past and upcoming appointments
- Request refills of medications
- View lab results
- View referral details
- Complete health questionnaires prior to appointment.