Print and fill out the appropriate forms and bring them with you to your appointment.
If you have any additional questions or need a form not listed here, please call POA at 425-656-5060.
New Patient Forms
Other Patient Forms
- Medical Records Release Authorization Form (PDF) Medical Records release requests must be made in writing. Please fill out and submit the completed form to our office via fax 425-656-5047 or in person at our front desk. Please allow 14 business days for completion.
- Notice of Privacy Practices (PDF) At POA, we keep record of the healthcare services we provide you and do not disclose this record to others unless you instruct us otherwise. Fill out this form to let us know who we can contact with your information.
- Back and Neck Form (PDF)