Patient Forms

Patient Forms

Preparing For Your Visit


We are excited to partner with you around your female healthcare needs!

 


To expedite registration, please arrive early to your appointment with the following paperwork fully complete.

 


This will give us the information we need to take the best possible care of you.

 

Select the option that describes you:

For additional assistance, please call 206-215-6300 Monday - Friday 8 a.m. to 5 p.m.


Forms for New Patients

 

 

Please arrive at least 20 minutes prior to your scheduled appointment time.

  1. Registration Form
  2. MyChart Access Agreement (used to establish online access to your health information via MyChart)
  3. New Patient Intake Form
  4. Authorization for Disclosure of Health Information (used to transfer medical records from an outside facility)

If you are coming to us from a provider outside of Swedish, it is helpful for your physician to have copies of the following from your previous or referring provider:

  • Your most recent health history and physical
  • Your most recent diagnostic studies (pap or other relevant gynecological tests)
  • Any operative reports
  • Any imaging reports

Expecting mothers should fill out this form along with any new or established patient paperwork.

  1. Prenatal Health Questionnaire

Forms for Established Patients

 

 

 

  1. Established Patient Annual Exam Form

There is no need to fill out additional paperwork, unless you have not yet signed up for MyChart.

  1. MyChart Access Agreement (used to establish online access to your health information via MyChart)
  2. Washington State Birth Certificate form

 

    Contact Information

    Swedish HealthCare For Women Clinic
    1229 Madison St.
    Nordstrom Tower, Suite 1450
    Seattle, WA 98104
    Phone: 206-215-6300
    Fax: 206-215-6301
    Monday-Friday, 8 a.m.-5 p.m.


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    An easy way for you to access your Swedish health information online, quickly and securely.


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