Alpine Integrated Medicine | Redmond, Washington | reception@alpineintegratedmedicine.com | (425) 949-5961

 

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Patient Intake Forms

Please click the icon below to download our new patient intake form.  You will also need to sign a HIPPA compliance form in the office before your first visit.

 

The intake for AIM visits is a bit longer than a traditional medical intake form, because of the comprehensive nature of the care provided.  Take your time, and give us the whole story.

 

This form is required for all new patients, and many patients find it convenient to fill it out ahead of time and email it to our receptionist at reception@alpineintegratedmedicine.com.

 

Remember to also bring your ID and your most current insurance card.

Concierge Wellness Serivce Agreement

AIM provides premier care through our Concierge Wellness Service.  Naturopathy/Primary Care patients are required to agree to one of three options in order to receive care at AIM by filling out this agreement.  

This form details the costs and benefits of each option, and asks for your payment information and preferred doctor. 

Just fill out the form and bring it in to your next visit, mail it, or fax it to us.  If you have questions, just ask!