11415 Slater Ave. Northeast, Kirkland, WA 98033

New Patients

For Our New Patients…

We are glad that you have decided to join us, and we look forward to working together with you.  Below are a few items to review to help you become acquainted with our Health Center.  If you have any questions, please do not hesitate to contact us.


Please see our Contact page for complete directions to our clinic.

Patient Forms

For your convenience, please download, complete, and sign the following Health Center forms prior to your first appointment.  The forms use Adobe Acrobat Reader. If you don’t have a copy of Acrobat Reader, you can click the icon below and download it for FREE.

Get the Adobe Reader here.

Clinic-Patient Agreement

This form explains the guidelines and policies that we use to provide you with the highest quality of medical care. To download the form, click here.

Financial Policy

This form explains our policies for payments and deductibles. To download the form, click here.

Privacy Practices Acknowledgement (HIPPA)

This form explains how we comply with the Health Insurance Portability and Accountability Act (HIPPA) to protect your personal information. To download the form, click here. For more information about HIPPA, visit the Health and Human Services Website here.

Authorization for Release of Health Care Information and Records

This form allows us to view and use your medical records and to provide these records and information to our medical partners. This allows us to more efficiently and effectively care for your medical needs. To download the form, click here.

Patient Information Sheet

This form contains general information about you that our doctors and staff use to expedite your health care. To download the form, click here.


Medical History

This form contains information on your current and past medical history. To download the form, click here,

How this injury has affected me (Impairment Ratings Only)

If you are coming in for an impairment rating, use this form to record how the injuring has affected your ability to perform tasks and activities. To download the form, click here