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Forms

  • Authorization to Release Confidential Health Information (PDF Download)
  • Consent For Treatment Form (PDF Download)
  • Insurance Verification and Benefits (PDF Download)
  • New Billing Notice - January 2022 (PDF Download)
  • Notice of Privacy Practices Form (PDF Download)
  • Patient Information Form (PDF Download)
  • Patient Profile (PDF Download)
  • Visit Cancellation Policy 2017 (PDF Download)

Contact Info:

110 James St #103
Edmonds, WA 98020

P: (425)835-0359

F: (425)835-0821

info@sagemedclinic.com

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