Open Tuesday–Saturday (procedure-focused Fridays) · 1109 Frontier Cir E, Lake Stevens, WA 98258 425-546-4804 · TeamWellnessLakeStevens@yahoo.com

Patient forms

New patients can complete paperwork at the clinic or request forms in advance. Start with a $100 visit or send us a message and we will email the packet.

  • New patient intake form
  • HIPAA notice of privacy practices
  • Release of liability
  • Patient model and social media agreement
  • Botox party information and agreement form

Accessibility requests outside of patient care can go to Community Access Coordinator Jerod Proulx at 425-546-4804 or TeamWellnessLakeStevens@yahoo.com.

Patient paperwork at the Team Wellness front desk

Email me new-patient forms

Prefer to talk first? Tell us what you need and we will reach out. Most new patients start with a $100 medical visit.

Thank you. We received your request and will contact you shortly. You can also book online now.
Something went wrong. Please call 425-546-4804 or email TeamWellnessLakeStevens@yahoo.com.

We typically respond the same business day. This form is not for emergencies. Call 911 for medical emergencies.

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