New Patients

New patient forms and information

Before your appointment, download, fill out, and send completed form(s) addressed to New Patient Services by Submitting Online, Fax, Email, or Mail.

• New Patient Registration Form
  General Information about you, your general practitioner, and insurance.
• Patient Release of Information Form
  Form allowing Salish Cancer Center to provide protected health information (PHI) to an individual or entity authorized by patients.
• Acupuncture Patient Form
  A few questions before your next Acupuncture appointment.
• Patient’s Rights and Responsibilities
• Salish Natural Products Policy
  
  

  Submit Your New Patient Forms

  Name(Required)

  First Last

  Phone(Required)

  Email

  Additional Comments

  File

  Drop files here or Select files

  Max. file size: 50 MB.