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Thank you for visiting our website.
If
you are interested in scheduling an appointment with either
Dr. Seligman or Dr. Lecovin, please call the clinic at 425
646-4747 and we will try to accommodate your schedule.
Please
read our insurance page to learn more about your benefits.
Please
print all of the new patient forms below and have them completed
for your initial visit.
Patient
Registration (
form
)
Patient
Health History (
form
1 )
( form
2
)
Patient
Consent (
form
)
Health Insurance Portability &
Accountability Act
HIPAA compliance
(
form
1 )
( form
2
)
Records
Release Authorization
(
form
)
Insurance
Questionnaire
(
form
)
Insurance
Notification
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