Patient Forms

FOR YOUR CONVENIENCE

We have made commonly used patient registration forms available for printing. Please bring completed forms to your first visit. We ask that you come twenty minutes prior to your first appointment time to allow for data entry. Feel free to come earlier if you have any questions about the forms.

New Patients and Patients that haven’t been in for 3 Years, please fill out all three forms.

Established Patients that have not been seen in the last 12 months are required to fill out just the ‘Review of Systems’ form.

PATIENT FORMS
*Please print all 3 forms for registration

Patient Registration Review of Systems Financial Policy

RELEASE OF RECORDS

Authorization to Release Healthcare Information – Records are typically sent out within one week from receipt of signed release.

Release of Records Form

 

e-Statements/Payment Portal

e-Statements and/or view previous statements using the Payment Portal.

Telehealth

If you have a scheduled Telehealth appointment please use appropriate URL below (Cut and Paste).  There is no password needed.  Please wait on the site for the MD or Therapist to arrive.  If you have been waiting more than 15 minutes please call our clinic at 206-292-6252.

https://doxy.me/SHSGDaruwalla

https://doxy.me/SHSGJoneschild

https://doxy.me/SHSGMiyano

https://doxy.me/SHSGTing

https://doxy.me/SHSGWagner

https://doxy.me/HandTx