Patient Resources

Patient Information

Everything you need to prepare for your visit — forms, insurance, and what to expect as a new or returning patient.

New Patients

We are currently welcoming new patients. To help us serve you efficiently, please review the information below and complete your intake forms before your first appointment.

1

Call to Schedule

Contact our office at (435) 787-7001 to schedule your first appointment. Our team will confirm your insurance and answer any questions. This can be done by phone or text message to the same number.

2

Complete Your Forms

Download and complete your patient intake forms before your visit. Bring the completed forms with you, or arrive 15 minutes early to fill them out in the office.

3

What to Bring

Please bring a valid photo ID, your insurance card, a list of current medications, and any relevant medical records or referrals.

Patient Forms

Download, print, and complete these forms before your appointment to save time at check-in.

New Patient Intake Form

General health history, demographics, and contact information for new patients.

Link coming soon

HIPAA Notice of Privacy Practices

Our notice describing how your medical information may be used and disclosed and how you can access this information.

Link coming soon

Consent to Treatment

Authorization for examination and treatment by Mt. Naomi Women's Health providers.

Link coming soon

Insurance Verification Form

Current insurance information and authorization for billing your insurance provider.

Link coming soon

Need help with forms? Call us at (435) 787-7001 and our staff will assist you.

Accepted Insurance Plans

We work with most major insurance carriers common in northern Utah. If you do not see your plan listed, please call our office — we are happy to verify your coverage.

SelectHealth
Regence BlueCross BlueShield of Utah
University of Utah Health Plans
Cigna Healthcare
Aetna / CVS Health
Molina Healthcare
Health Choice Utah
PEHP (Public Employees Health Program)
DMBA (Deseret Mutual Benefit Administration)
United Healthcare
Medicaid (Utah)
Medicare
CHIP (Children's Health Insurance Program)
Tricare

Insurance plans and coverage details change frequently. Please contact your insurance provider and our office to confirm your specific benefits before your appointment.

Office Policies

Appointments

Please arrive 10–15 minutes early for your first visit. If you need to cancel or reschedule, kindly give us at least 24 hours notice.

Prescription Refills

Please request prescription refills at least one week before you run out. Contact your pharmacy first, and they will send a request to our office.

After-Hours Care

For urgent medical concerns after hours, please call our main number at (435) 787-7001 and follow the prompts for the on-call provider.

Medical Records

To request a copy of your medical records, please contact our office. A signed release form is required. Allow 5–7 business days for processing.

Questions Before Your Visit?

Our team is happy to help. Give us a call or send us a message and we will get back to you promptly.