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Forms and Documents

Download any required forms or informational documents here.
All files in PDF Format.

Forms Information Packets
 Download Adult Medical History Information
File Size:183.67 Kb

 Download Acknowledgement Of Receipt Of Privacy Practice Notification
File Size:177.2 KB

 Download Patient Registration Form
File Size:174.2 KB

 Download Authorization To Leave Health Information By Alternate Means
File Size:171.5 KB

 Download Washington State Advanced Directive
File Size:342.42 Kb

 Download Authorization To Release Medical Records
File Size:191.61 Kb

 Download Pediatric Medical History Information
File Size:161.68 Kb

 Download Charis Cares Enrollment Pack
File Size:461.1 KB

 Download New Patient Information
File Size:312.92 Kb

 Download Notice Of Privacy Practices
File Size:96.0 KB

 Download Financial, Payment, and Other Policies
File Size:365.56 Kb

 Download Charis Care Member Services Guide
File Size:711.2 KB

Document Sets (ZIP)

You will need a program to unzip these files.

File Size:1,379.06 Kb

 Download ALL FORMS (ZIP File)
File Size:1,734.14 Kb