202 Prospect Dr., Glendive, MT 59330
Hospital: 406-345-3306 | Fax: 800-660-4325
Forms for Patients
The forms below can be printed and filled out. You can return the form by fax, mail or by bringing it to our Health Information Management Department(HIM). The HIM department is located in the basement of Gabert Clinic across from the Carney Center. If bringing the form directly to the office, photo id is required. Behavioral Health records require specialized paperwork, in order to access those records please come to the HIM department.
Information Release Form
Authorization for Release of Medical Information
The following form(s) can be printed and filled out and brought to your appointment at Gabert Clinic. The form(s) must be filled out for insurance purposes so filling them out in advance will cut down your registration time.
Workers Compensation Information Form