New Patients
Lynn Chadd
Home
Bio-Identical Hormones
Medical Thermal Imaging
New Patients
About Us
Purchase Supplements
Upcoming Seminars
Newsletters
Contact Us
Bookmark & Share
New Patient Information Form

New Patient Consults can be scheduled in person in Peshastin or Poulsbo, Washington. New Patients Consults can also be done by telephone.

New Patient forms must be completed prior to Scheduling your consultation.

we do not bill insurance
New Patient Forms

Click here to begin the Women's online form
Click here to begin the Men's online form

Both the online form and the pdf form contains:
1. Client Provider Agreement.

2. Medical History Intake Form. This must be completed and received before making your appointment.

3. Information regarding general expenses, Payment Policy, and Tips for billing your insurance company.

Alternate Option
Or you may send this information to us by mail or by fax.

Click here for the PDF version of the Women's online form.
Click here for the PDF version of the Men's online form.

Fill out the form and then send it to us by fax or by ordinary mail before your initial consultation to:

Fax: (509) 548-1879

10090 Main Street, Suite H, Peshastin, WA 98847