New Patient Forms

****For the safety of our patients and staff, we respectfully ask that you wear a cloth or surgical face mask that covers your mouth and nose the entire time you are in the building. Please no masks that are mesh and/or have holes. We apologize, but there are no medical exemptions for medical facilities. If you are unwilling to wear a face mask you will be politely requested to leave. Thank you for your understanding.

Please click on the link below for the new patient packet that you will need. YOU WILL NEED A PRINTER. Please select the print button at the top of your screen. Once the packet is printed out please fill it out and bring it in with you at the time of your appointment. Please be sure to inculde the new patient form, privacy policy, and no show policy in each packet. Thank You.

New Patient Packet

Please print and fill out this packet for any patient 6 yrs or older. Bring to your first appointment with us. Thank you!

Pediatric New Patient Packet (6yrs & younger)

Ages 6 and under- Parents (guardians), please print and fill out the entire packet to bring in with you to your child's appointment.

EPFX Biofeedback Form (SCIO)

Please print and fill out this form ONLY if you are being seen for biofeedback.

Acute New Patient Packet

Please print and fill out this packet ONLY if you have been requested to do so.

Medical Records Release TO Colville Naturopathic Clinic

Please print, fill out, sign and then submit to either the facility holding your records or to our office.

Medical Records Release FROM Colville Naturopathic Clinic

Please print, fill out, sign and then submit to our office.

Note: To download Adobe Acrobat Reader for free, click here.