Click a link below to download and print a PDF form.
New Patient Brochure
Please read the new patient brochure for complete details and information regarding your appointment.
New Patient Forms (3)
Fill out all 3 of these forms completely and bring to your appointment. If your appointment is more than a week away, you may mail them back to the office.
School Forms (3)
Please complete the lower portion of this form and fax back to the office that you go to, Att: Nurse Triage.
Immunotherapy Form
If you have checked with your insurance and have now decided to either start a Program of shots or want to request a renewal of your antigen, fill out this form and fax it to the Seattle office at: 206-523-0724 Att: Antigen Department.
Click here to download form
Medical Record Form
Please complete and fax to the Seattle office at: 206-523-0724 Att: Medical Records Department.
Click here to download form
EZ Pay Form
This will allow us to automatically charge your credit card for regular shot co-pays and other patient responsibility balances that you may authorize. Fill out the form and fax it to: 206-527-0535. You may also scan and send to: ptaccounts@nwasthma.com
Click here to download form
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