Patient Forms

At your first appointment, you will need a completed patient 福利免费体验区av and health history form. It is helpful if you complete these in advance, and bring along copies of previous tests, lab results, and the names of medications or natural supplements you are currently taking.

All patients must complete the following form and bring them to their first appointment. 

Other important forms:

Service Specific Forms

 

 

If you are scheduled for a Mind Body visit, please review this and fill out these . 

If your physician recommends it, please fill out the

If you are requesting your medical records be released to or from our clinic, please fill out the corresponding . 

A parent/legal guardian must attend a minor鈥檚 first visit at Bastyr Center for Natural Health. For parents or legal guardians who cannot be present for subsequent visits, please fill out this form:  

To sign up for access to your child's MyChart record (children 11 and younger), please complete this form:  and email to [email protected]. Include Photo ID which is required to activate proxy. Please note that your child鈥檚 chart will be accessed through your MyChart record.  

For any patient 12 and older that would like a parent or a legal guardian to access their MyChart account, please complete this form: and email to [email protected]. 

After you鈥檝e scheduled your first visit, fill out these counseling intake forms and bring them with you to your appointment.