Online Patient Digital Forms
| Release of Medical Records Form | Release of Medical Records Form |
| Patient Registration Form | Patient Registration Form |
| HIPAA Privacy Notice | HIPAA Privacy Notice |
| Notice of Privacy Practices Acknowledgement Form | Notice of Privacy Practices Acknowledgement Form |
New Patient Forms–English
Below you will find new patient paper forms that we use in our clinic.
- Patient Contact Form
- Patient Registration Form
- Notice of HIPAA Practice Policy
- Notice of Privacy Policy
- Medical Release Form
- Change PCP forms
Additional Patient Forms
- CCM Immunization Confirmation Letter
- School Immunization Questionaire
- Treatment Consent Form
- Acknowledgement of Review of Notice of Privacy Practices
- AMA-against medical advice
- Medical Record Authorization Form
- Health History Form
- WA Immunization Exemption Certificate
- Insurance and Payment Authorization
- Patient Heath History Form
- Pre-Participation Physical Evaluation
- Medical Release Form
- Patient HIPAA Notice
- Denver II Developmental
- More Forms on WA DOH
