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To make your visit go more smoothly, please download and print forms, then complete the information in advance of your visit to our offices. Please remember to bring the completed forms with you.
- HIPPA forms (required
by law of all patients).
- New Patient
Information Form (general information we need about you)
Patient Information
- Personal Medical
History Form (detailed history)
Patient History
- Medical Records Request Forms
Request Records to QA OBGyn
Release Records from QA OBGyn
To Download Files
Please right click on the link below, select "download linked file" to the location of your choice on your computer. In some web browsers, the forms may simply open in Adobe format.
If your computer lacks the appropriate software, please retrieve and install from:
We
appreciate your taking the time to complete any required forms.
(206) 781-1830
Located in Queen
Anne Square
just west of
the Seattle Center
220
West Mercer St Suite 110
Seattle,
WA 98119