New Client Agreement

If you would like to save yourself some time or make yourself aware of how our office works, please print, read, and sign our new client agreement. Please bring in the last page to your appointment for our records. 

*our initial intake appointment requires the input of your demographic information and a few history questions via our iPad Electronic Health Record system, so you will still need to arrive early for your first appointment to complete this. 

New Client Agreement

Release of information

If you are transferring care from another provider, coming to see one of our Nurse Practitioners for medication management, or have other providers in the community you would like us to collaborate with, please print and sign this form, and bring it to your appointment. 

Mountlake Terrace Release

Northgate Release

Psychiatric Intake Form

Please print and fill this form out entirely prior to the start time of your first medication management evaluation appointment. Your Nurse Practitioner will use this history to guide their initial evaluation, allowing them to focus on the areas of greatest concern during your session. If you choose not to fill it out at home or don't have a printer, please arrive at least 30 minutes prior to your first appointment to complete it in our office. 

Mountlake Terrace Psych Intake

Northgate Psych Intake