Patient Forms

Please follow the link below to complete your forms. Once submitted, they will be securely sent to a member of our staff for review. If there are any issues or missing information, we’ll reach out to you directly.

Please note: if a membership fee applies to your appointment, payment must be made before submitting your paperwork.

If you are visiting our office for Weight Loss or Nutrition services only, the membership fee does not apply. All other appointment types are subject to the membership fee of $240 for adults and $25 for patients under the age of 26.

If you have questions regarding which forms pertain to your scheduled appointment, please contact our office at 253-268-3345.

New  Patients:

• General New Patient Forms
• New Patient IBA Forms (Medical Weight Loss Program)
• New Patient Nutrition Forms

Established Patients:

• Established Patient IBA Forms (Medical Weight Loss Program) 

General Consents:

• Telehealth Consent Form
• Consent to Treat Form 
• Medicare ABN (Advance Beneficiary Notice of Non-coverage)