To make an appointment, please call (253) 848-8797 or schedule with Woodcreek online.
Woodcreek Healthcare Patient Forms
For your convenience, click on the form(s) you need, download, print and complete. You can either bring it with you to your next visit or mail it to Woodcreek Healthcare.
Registration (PDF) - This form is required to register new patients and is used to update information on established patients.
Advance Consent to Treat a Minor (PDF) - Parents or guardians provide consent for their children under the age of eighteen to be treated without a parent or guardian present.
Authorization for Health Care of a Minor (PDF) - Parents or guardians can temporarily entrust decisions about their child’s medical treatment to a babysitter, relative, or other temporary caregiver. The form allows specified caregivers to access medical care for the child without delay, especially during emergencies. This form will be kept in the child’s medical record.
Authorization to Use or Disclose Protected Health Information (PDF) - Use this form to authorize Woodcreek to exchange medical records with other health care providers.
Parents of Adolescent Girls (PDF)
Preparticipation of Physical Evaluation History Form (PDF) - This form is to be filled out by the patient and parent prior to each annual well child exam for all children ages 11 years and older.
Developed by a coalition of 6 leading medical societies, the Preparticipation Physical Evaluation History Form is a screening tool to help identify diseases or processes that may affect an athlete's participation in physical activity. The questions are designed to assess the athlete's (or active person's) general medical history and probe potential issues related to cardiovascular problems, the central nervous system, pulmonary system, gastrointestinal/genitourinary systems, dermatologic conditions, musculoskeletal concerns, and the female athlete. The completed form will be kept in the child’s medical record for any future activity requiring a physical prior to participation (e.g., sports, camp, etc.).
Providing Health Care to Minors (PDF) - A summary of health care services that can be provided to minors without parental consent
Request to Correct or Amend Protected Health Information - This form is used if – upon review of your or your child’s medical record – you find something that you believe does not belong in the record. You have the right to request that your provider correct (edit) or amend (add information to) the medical record to make it more accurate or complete. Please fax this form to (253) 845-0100 or mail to Woodcreek Healthcare – Quality Services Department, 11102 Sunrise Blvd E, Ste 103, Puyallup, WA, 98374.
Informed Consent Agreement To Bill Personal Injury Protection (PIP) Insurance for Motor Vehicle Accident (MVA) Visits - This form authorizes Woodcreek to bill your Personal Injury Protection (PIP) insurance on your behalf when you seek medical care after a Motor Vehicle Accident (MVA). Woodcreek does not bill health insurance for visits related to a MVA.