Please take the time to carefully read, fill out and sign these documents. Some of these forms require sincere thought so please take your time.  They are required during your first visit.  Most importantly fill out the Intake forms and bring them into your initial visit or even better you can fax/ mail them in before your visit.  If you choose to mail them please make a copy in case they are not received before your visit.  If you have questions about any of the documents please discuss them with Dr. Silapie before signing them.

INTAKE FORMS

1. •   Health History:
   

2. •   Adult
   

3. •    Infant to five
   

4. •    Pediatric to Adolescence   
   

5. •    Wheel of Life
   

6. •    Context of Care
   

PRIVACY

1. •    Informed Consent
   

2. •    Disclosure of Records
   

POLICY

1. • Financial Policy
   

2. • Health Privacy Policy

251 N. Main Ave, Ste. 103  White Salmon, Wa  98672

Ph: (509)493-3300      Fx: (509)493-3700

Patient Forms