All new patients must fill this form out.
All new patients must fill this form out.
Clients claiming personal injury must fill out this form.
Clients claiming Labor and Industries or Personal Injury must fill out this form.
Labor & Industries need to fill out page one only.
Personal Injury clients need to fill out both pages.


4200 6th Ave. Suite #202
Lacey, WA 98503
(360) 539.7726
(360) 539.7729
Mon-Fri 10:30am-7pm
Sat 11am-4pm