Providing the best medical care for our community

Registration

New Patient Registration

BUIHWC is offering tele-health services at this time. For those wishing to register for our Center, please call our office at 406-534-4558 and our staff will assist you
OR complete and submit the New Patient Registration form below. A member of our office will follow-up with your form submission.
We are open Monday- Thursday 8:00 a.m. – 5 p.m. and Friday 8:00 a.m. to 12 p.m.  to set up appointments and registrations.
Please be advised – During the registration application, you will be asked to attach/upload a copy of your Photo ID / Tribal Enrollment and Insurance (if applicable) to the registration form. This is required as part of the registration process. You can either attach it to the website patient registration in the upload section, email us our email a clear copy to our front desk at kme@buihwc.com, or bring them in so we can take copies.

Step 1 of 5

  • Patient's Legal Name
    Pronoun Descriptions: Feminine: She, Her, Hers, Herself Masculine: He, Him, His, Himself NE: NE, NEM, NIR, NIRS, Nemself Neutral: They, Them, Their, Theirs, Themselves Other: OTH Spivak: EY, EM, EIR, EIRS, Emselves VE: VE, VER, VIS, Verself XE: XE, XEM,XYRS, Xemself ZE-HIR: ZE, HIR, HIRS, Hirself ZE-ZIR: ZE, ZIR, ZIRS, Zirself
  • Date Format: MM slash DD slash YYYY