Name:

Address:

Referral Person:

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Preferred Date:

     
 
  Office Specials:  
 


Why wait days or weeks for an Appointment?


Call 208.466.2456 now and get in within 24 hours!
Or click HERE to schedule an appointment now!!

 

We are currently accepting NEW PATIENTS!!
This is our gift to you for becoming a new patient.


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The Procrastinator Special
If it has been too long since you have been in to see us, please take advantage of this offer!!


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First Time Appointments
 
In order to add convenience and speed to the process for new patients of Drs. Kim Keller and Amelia Justin, we are providing the necessary forms available for download and completion at home. Print them and fill them out at your convenience before coming by the office. If you have any questions, concerns or want us to send you the forms by mail, please feel free to Contact Us.
 

Patient Information Form

Health History Form

If you unable to view PDF files on your computer, you can download Adobe Acrobat Reader free directly from Adobe.