Patient Forms

At your first appointment at Bastyr Center, you will be asked to complete a patient information form and health history. It is helpful if you bring along copies of previous tests, lab results and the names of any medications or natural supplements you are currently taking. You can also save time by bringing the completed forms with you on your first visit. (Download free Adobe Reader software.) Download and print the PDF documents below. Then bring the completed paperwork with you to your first office call:

Additional Forms

  • For a nutrition visit, please also fill out this form: Nutrition Assessment.
  • For a visit to the Diabetes and Cardiovascular Wellness Clinic, please also fill out this form: DCWC Intake Form.
  • If your physician recommends it, please fill out the Digestive Questionnaire Form.
  • If you are requesting your medical records be released to or from our clinic, please fill out the corresponding release form.

A parent/legal guardian must attend a minor’s first visit with Bastyr Center for Natural Health. For parents or legal guardians who cannot be present for subsequent visits, please fill out this form: Permission to Treat a Minor Without a Parent/Guardian Present.