Forms

New Patient Information and Forms

Prior to your first visit, we ask that you download the New Patient Registration Packet and bring the completed forms with you to your first appointment. Todas formas en Español.

 

In addition, please select the form for the body area that focuses on your chief complaint.

HIPAA Privacy Policy   Please read

(Note: you are not required to print this policy. The Privacy Policy Signature Page is included in the New Patient Registration Packet)

 

Additional Misc. Forms

Children Accomanying Patients

 

Please be sure to bring the following items with you to your first appointment:

  • The completed forms listed above.
  • Comfortable clothing as noted below:
  • For low back pain or lower extremity problems, please bring shorts and a t-shirt.
  • For females with back, neck, and/or upper extremity problems, please bring shorts and a halter-top, bathing suit top, or one-piece backless bathing suit. Note that a sport back jog bra obscures viewing of the shoulder blades and is not recommended.
  • Your current insurance card(s).
  • A method of payment (i.e., checkbook, credit card, etc.).

 

Insurance Accepted:

The following is a list of the major insurance plans we accept. Please contact us for more information if your plan is not on the list below. We will help you determine if your specific plan is accepted.

  • Medicare
  • Premera Blue Cross
  • Cigna
  • Asuris
  • Community Health Plan of WA
  • Soundpath
  • Health Alliance
  • Molina
  • Labor & Industries
  • Workers Compenstaion
  • Blue Cross/Blue Shield
  • First Choice
  • Medicaid
  • Motor Vehicle Accient Insurance-PIP
  • TriWest
  • TriCare
  • Regence
  • United Healthcare.