| Form | |
|---|---|
| Release of Medical Records Form | Download |
| Patient Registration Form | Download |
| HIPAA Privacy Notice | Download |
| Notice of Privacy Practices Acknowledgement Form | Download |
Below you will find new patient forms that we use in our clinic. Feel free to download the forms and fill out these forms at home to ease your first visit:
Below you will find new patient forms that we use in our clinic. Feel free to download the forms and fill out these forms at home to ease your first visit:
Below you will find new patient forms that we use in our clinic. Feel free to download the forms and fill out these forms at home to ease your first visit:
| Form | |
|---|---|
| CCM Immunization Confirmation Letter | Download |
| School Immunization Questionaire | Download |
| Historia De Salud De Su Hijo (Patient Health History) | Download |
| Treatment Consent Form | Download |
| Acknowledgement of Review of Notice of Privacy Practices | Download |
| AMA-against medical advice | Download |
| Medical Record Authorization Form | Download |
| Health History Form | Download |
| WA Immunization Exemption Certificate | Download |
| Insurance and Payment Authorization | Download |
| Patient Health History Form | Download |
| Pre-Participation Physical Evaluation | Download |
| Medical Release Form | Download |
| Patient HIPAA Notice | Download |
| Denver II Developmental | Download |
| More Forms on WA DOH | Download |
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