For Your Appointment

Below you will find the Registration Forms we need to have in your file.  To save time please print, read, and complete these forms then bring them with you to your appointment.

Doctors Hours:

7:00am to 5:00pm on Mon, Tu, Th, Fri.
7:00am to 8:00pm on Wednesday.
8:00am to 2:00pm on Saturday.

Phone:  425 885-6600
            800 935-2015
Fax:       425 885-6580

Registration Form Instructions

Parents and guardians please complete the forms on your child's behalf if he or she is under age 18.

• New patients: 

           Adult (18 and over):       Please read and complete Forms 1,2,3,4 and 5.
           Child  (under 18):           Please read and complete Forms 1,2,3,4 and 6.

• Established patients:       Please read and complete Forms 1,2,3 and 4.

Form #1: General Appointment Information 

Form #2: Notice of Privacy Practices 

Form #3: Acknowledgement of Privacy Practices 

Form #4: Patient Medical History

Form #5: Adult Registration

Form #6: Child Registration