PRINTABLE FORMS

Save time by printing and filling out the applicable forms below. Just bring the filled out forms with you to your appointment.

MEDICAL HISTORY

HIPAA AGREEMENT

CONSENT-TO-TREAT FORM

 

360.794.8947 fax

EvergreenHealth Pavilion
14841 179th Ave SE
Suite 340
Monroe, WA 98272

360.794.7520 phone

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