To request an appointment with Dr. Dalili or Dr. Krumbeck please fill out the form below.

Here’s what to expect:

  1. Fill out and submit the short request form below.
  2. You will receive an e-mailed intake form shortly.  (This typically happens within the hour, but may rarely take up to 2 business days.)  This longer intake form is specific for each doctor and type of health condition.
  3. Fill out and submit the online intake form and sign electronically. (We like to save trees by skipping paper forms!)
  4. After submitting you will receive a phone call to place yourself or your child on our appointment schedule.  It is required to fill out the longer intake form before scheduling – it helps us meet your very specific healthcare needs and provide the best possible care.

If during any step you do not hear from us please e-mail or call (406) 552-1717.   We always strive to provide the best possible service, but computer glitches have been known to happen.