Below you'll find forms that may be applicable to your primary or specialty care appointment or procedure. Complete and return them as requested by your ...

Forms. UW Medicine Notice of Privacy Practices Acknowledgement · UW Medicine Care Agreement · UW Medicine Financial Agreement ...

To refer patients to the Family Planning Clinic at UWMC-Roosevelt: Call 206.598.5500, or complete the UW Medicine Referral Request Form and fax it to 206.598.

Sign the PCISA Form, Report a Compliance Concern, Review the UW Medicine Compliance Code of Conduct, UW Medicine Compliance Policy Guidance, Forms & Templates.

Here you will find any of the forms you may need in order to meet the immunization requirement, establish health insurance, establish medical care, request ...

All requests for Services must be submitted to Pathology on a Pathology Reference Laboratory Service Request form. Specimens must be properly prepared and ...

You can request medical records with our online tool and have the records delivered right to you — no need to go and pick them up. Choose from electronic or ...

Patient Authorization for UW Medicine to Obtain Protected Health Information From ... Please read and complete the entire form in order for UW Medicine to process ...

25 янв. 2024 г. · The form is located on uwmedicine.org under Patient Forms for Primary Care. If your child has not had a Wellness exam in the past 12 months ...

Download and complete the registration forms below. When you arrive to your first appointment, we will also have you submit a patient health history.