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Forms to View or Download
“CONFIDENTIAL PATIENT INFORMATION” All new patients are require to write-in this confidential form before an exam or consultation. • New Pediatric or Adolescent Patient Form “PEDIATRIC/ADOLESCENT PATIENT CONFIDENTIAL INFORMATION” form The parents of new patients under their care are require to fill out this confidential form before an exam or consultation. • For medical information to be transfered to or from Dr. Ruhland
“AUTHORIZATION TO RELEASE CONFIDENTIAL HEALTH INFORMATION” form |
John F. Ruhland, ND — The Natural Health Medical Clinic, LLC 206-725-7707 If no answer, call 206-723-4891 and email us: info@drruhland.com 4002 25th Avenue S - on Beacon Hill just south of downtown Seattle We don’t discriminate on the basis of race, religion, ethnicity, age, class, country of origin, gender, or sexual orientation. Please leave cell phone and wireless devices in your car, and perfume/cologne in its bottle.
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