Bonney Lake Medical Center
Bonney Lake Medical Center

Patient Forms

Welcome Letter
Welcome Letter 0210 (1).pdf
Adobe Acrobat document [20.7 KB]
Release Authorization
Release Authorization 0210.pdf
Adobe Acrobat document [34.1 KB]
Patient Information
Patient Info 0210.pdf
Adobe Acrobat document [39.0 KB]
Notice of Privacy
Notice of Privacy Practices 0210.pdf
Adobe Acrobat document [35.0 KB]
Health History
Health History 0211.pdf
Adobe Acrobat document [389.5 KB]

Want to save time during your visit with us? Please print and fill out the following forms and bring with you on your first appointment.

Don't forget to bring your insurance information with you

In order to register and treat you promptly, we request that our patients bring their current insurance information with them for each visit.

We accept most types of health insurance. Please contact us for further details.

Important telephone numbers for in case of emergencies:

Pierce County Crisis Line                     253-798-6595
Emergency Services & Fire Department 911
Centers for Disease Control and Prevention 800-CDC-INFO (800-232-4636)
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