Primary Care Patient Forms

You'll get the most out of your EvergreenHealth Primary Care visit if you come prepared. This page has the forms you can complete in advance.

Forms for new patients

If you’re new to our practice or have not been to it within the last year, download and complete the following forms and bring them with you to your appointment. Rely on our team to inform you which forms you will need.

Adult forms

Depending on the reason for your visit, you may need to complete:

Individuals Involved in Care [PDF]

Adult Health Annual Exam Questionnaire [PDF]

Adult Health Questionnaire [PDF]

Pediatric Health Questionnaire [PDF]

Consent to Treat a Minor [PDF]

Adult Visit – Medicare [PDF]

Pediatric forms

Before your child’s visit, you’ll need to complete:

Pediatric Health Questionnaire [PDF]

Consent to Treat a Minor [PDF]

Forms for returning patients

Before your appointment, your doctor may ask you to complete a form:

Adult Returning Patient [PDF]

Pediatric Returning Patient [PDF]

Returning Medicare Patients [PDF]