Ballard

(206) 282-8120

Header Phone

(206) 282-8120

Queen Anne

206.282.8120

Roosevelt

(206) 282-8120

Our Clinics: Queen Anne (Temporary Closed) | Ballard | Roosevelt

Online Forms

At Eye Clinics of Seattle, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReaderĀ® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Patient Registration Form

Download & Print Form


Online Forms Portal

Fill-up Online


Records Request Form

Download & Print Form


Notice of Privacy Practices

Download & Print Form


Authorization To Release Healthcare Information

Download & Print Form



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