Please click on the name of a WWMG Care Center to skip to its forms:
Cardiology
Ear, Nose, and Throat/Allergy/Audiology
Endocrinology
Gastroenterology/Endoscopy
Nephrology
Orthopedic
Podiatry
Psychology
Pulmonary/Asthma
Ear, Nose, and Throat/Allergy/Audiology
Endocrinology
Gastroenterology/Endoscopy
Nephrology
Orthopedic
Podiatry
Psychology
Pulmonary/Asthma
Primary Care: Everett Family Medicine
Primary Care: Grove Street Family Clinic
Primary Care: Lake Serene Clinic
Primary Care: Marysville Family Medicine
Primary Care: Snohomish Family Medicine
Primary Care: Whitehorse Family Medicine
Rheumatology
Sleep Medicine
Surgery Center
Primary Care: Grove Street Family Clinic
Primary Care: Lake Serene Clinic
Primary Care: Marysville Family Medicine
Primary Care: Snohomish Family Medicine
Primary Care: Whitehorse Family Medicine
Rheumatology
Sleep Medicine
Surgery Center
Cardiology
- Patient Registration Form
- Consent to Release Information
- Fee for Records Policy
- New Patient Appointment Letter
- Privacy Policy
- No show/Cancellation Policy
Ear, Nose and Throat / Allergy / Audiology
- Patient Welcome Letter
- Patient Registration Form
- Medical History Questionnaire – ENT
- Medical History Questionnaire – Allergy
- Audiology Questionnaire
- Notice of Privacy Practices
- Acknowledgement of Receipt of Privacy Practices
- Cancellation Policy
- Communication Agreement
- Financial Agreement
- Consent to Release Information
Endocrinology
Family Practice Primary Care:
Everett Family Medicine
- Patient Registration Form
- Patient History – New Patients
- Everett Family Medicine Prescription Refill
- Privacy Policy
- Notice of Privacy Practices
- Consent to Release Information
- No Show Policy
- Consent to Treat a Minor
- Financial_agreement
- EFM – Authorization for Release of Information Form 2018
- Patient Health Questionnaire (PHQ.9 Form) – EFM
- Generalized Anxiety Disorder Screening (GAD-7) – EFM
- PHQ-A for adolescents
Grove Street Family Clinic – Marysville
Lake Serene Clinic – Lynnwood
- Patient Registration Form
- DOT Physicals
- Parental Consent Form
- MVA Payment Authorization
- PHI Disclosure Authorization
- Routine Preventative Healthcare Checklist
- Wellness Exam Insurance Info
- Privacy Policy
- No Show Policy
Marysville Family Medicine
- Adult Medical History Form
- New Patient Packet
- Integrative Medicine Intake Form
- Consent to Treat a Minor
- Release of Information
- FMLA Disability Information Worksheet
Snohomish Family Medicine
- Release of Information
- DOT Exam Checklist
- No Show Policy
- Patient Registration Form -Female
- Patient Registration Form – Male
- Pediatric Patient Registration Form – Female
- Pediatric Patient Registration Form – Male
- Wellness Forms Female
- Wellness Forms Male
Whitehorse Family Medicine – Arlington
- New Patient Registration Packet
- WWMG Family Friends Consent
- Consent to Treat a Minor
- DOT Appt letter-WFM
- Wellness Exam – Female
- Wellness Exam – Male
- Review of Systems
- Pain Inventory Handout
- Med Hx Form
- COMM-Current Opioid Misuse Measure
- Generalized Anxiety Disorder Screening (GAD-7)
- PHQ.9 Form
- PHQ-A for adolescents
- Consent For Flu Vaccine
- Medical Records Release Form
Gastroenterology / Endoscopy
- GI New Patient Packet
- GI Return Patient Packet
- Endoscopy Primary Packet
- Release of Records Authorization
- Preparing for a Procedure? Click here for instructions
Nephrology
- Welcome Letter
- Patient Registration Form
- Health History
- Financial Agreement – Nephrology
- No Show and Cancellation Policy
- Consent to release information
- Privacy Policy
- Acknowledgement of Receipt of Notice of Privacy Practices
Orthopedic
Podiatry
- Podiatry New Patient Packet
- Notice of Privacy Practices
- Consent For Minors – Podiatry
- Authorization for Release of Information
- Refurbishment of Orthotics
Psychology
Pulmonary / Asthma
- Appointment Policy – Pulm
- Patient Registration Form
- Consent to Release
- WWMG Financial Agreement
- General Information
- General Edmonds Information
- PATIENT HISTORY QUESTIONNAIRE
- Patient Health History
- Privacy Policy
- Acknowledgement of Privacy Practices
Rheumatology
- Patient Registration Form
- WWMG Financial Agreement
- Release of Records Authorization
- Review of Symptoms – Bothell patients only
- Patient Health History – Everett patients only
Sleep Medicine
- Appointment Policy – Sleep Medicine
- Patient Registration Form
- Cognitive Behavioral Therapy for Insomnia
- Consent to Release
- WWMG Financial Agreement
- General Information
- Sleep Medicine General Information
- Patient Questionnaire
- Patient Health History
- Sleep Questionnaire
- Privacy Policy
- Acknowledgement of Privacy Practices
Surgery Center