What We Treat
Please download, print, and fill out each of the forms below and bring them to your first office visit.
MSA Health History Form
Authorization for Release of Individually Identifiable Health Information to Designated Party
If you would like to request a copy of your medical records, please fill out this form.
Medical Record Release Form
Once completed, mail form to:
PO Box 7609
Missoula, MT 59807
You’ve got questions. We’d love to hear from you.
500 W Broadway(5th Floor of the Broadway Building, attached to St. Patrick Hospital)
Missoula, MT 59802
© 2017 Missoula Surgical Associates
NOTICE OF NON-DISCRIMINATION AND ACCESSIBILITY RIGHTS