Download the necessary form(s), print it out and fill in the required information. Fax us your printed and completed form(s) at 206.212.7455 or bring it filled out with you to your appointment.
Auto Accident / Injury Forms - Required for any patient who has been in a car accident within the last month. If you are seeing Dr. Verhunce due to an injury: automobile, work, or other, please fill out this paperwork and bring it into the office for your first visit.
HIPAA - Notice of Privacy Practice
We are happy to provide this HIPAA compliant notice of our privacy practices for you. This document is a simple explanation of your rights about how, when, and why your health information may be disclosed. Please feel free to contact our office with any question or concerns you may have about this notice.