For your convenience, the following form is available to view, download and complete. Save some time and bring the form with you to your next visit or email it to contact@PugetSoundFamilyHealth.org

New Patients: Please fill out all pages of the form.

Established Patients: If a PSFH member has requested that you update your information, please fill out pages 1-4.

Medical Records Release Form

If you are requesting medical records we ask that you fill out the medical records request form. Please allow us 5 days to process the request after we receive the records request form.