The Everett Clinic: For the whole you.
Search
MY MEDICAL RECORD
PATIENT RESOURCE CENTER
About Us
Contact Us
Jobs
News
Physician Opportunities
Physicians
Medical Specialties
Locations
Walk-In Clinics
Pharmacy Services
Prescription Refills
Lab
Radiology
Vision
Children's Eyewear
Frames
Frequently Asked Questions
Reading Glasses
Sports Wear
Sunglasses
Hearing
Frequently Asked Questions
Good Communication Habits
Myths & Facts
Useful Links
MY MEDICAL RECORD
Health Library
Patient Resources
Home
»
PATIENT RESOURCE CENTER
»
New Patient Information
New Patient Information
In this section:
Adult Care Guidelines
Appointment Information
Choosing a Practitioner
Requesting a Referral
Frequently Asked Questions
Be a Patient Representative
Billing & Insurance
Insurance Plans
Community Classes
Diabetes Education
Groups
Flu Shot Clinic
Health Library
Medical Records & Privacy Info
Medicare Advantage
Free Informational Sessions
Accepted Plans
Questions & Answers
What is Medicare Advantage
New Patient Information
Senior Care Resources
Nutrition & Weight Management
Preventative Health & Wellness
Patient Doctor Relationships
Prescription Management
New Patient Forms
Adult Medical History Form
Adult Medical History Form
Medical Records Release Form
Use this form to request that another healthcare facility send your medical records to The Everett Clinic.
Consent to Leave Message/Share Information with Family/Friends
Bring The Following To Your First Appointment
Completed Adult Medical History Form
Completed Medical Record Release Form
Your Insurance Card (and/or coupon)
Your Photo ID
Your Copay (if you have one)
Any Prescription Medication You are Currently Taking (or a complete list)
Change of Address or Phone Numbers (if you’ve recently moved or made a change)