Patient Forms

Please arrive 15 minutes early to your first appointment to ensure completion of all necessary paperwork.

For your convenience and to expedite your check in process, download and complete the following forms (HIPPA, Patient information, and Functional Outcome Measure) and bring them completed with you to your first appointment.

Click the form links below to download printable versions of each form

Patient Information/HIPPA/Medical history form
Functional Outcome Measure
Additional forms to fill out if your primary insurance is Regence
Additional forms to fill if your insurance is Premera

Patient Forms

Please arrive 15 minutes early to your first appointment to ensure completion of all necessary paperwork.

Click the form links below to download printable versions of each form

Patient Information/HIPPA/Medical history form

Functional Outcome Measure

Additional forms to fill out if your primary insurance is Regence

Additional forms to fill if your insurance is Premera

Westgate Physical Therapy