Seattle Office

2501 N. 45th Street

Seattle, WA 98103

(206) 526-5222

(206) 675-1460

Bellevue Office

12402 SE 38th St

Suite 203

Bellevue, WA 98006

(425) 454-0200

(425) 454-2345

Online Forms

At Puget Sound Eye Care, we value your time. In an effort to save you time in our office , you are able to fill out our welcome forms through our online patient portal. Click the link below to get started.

  • If you are a new patient, click "New Patient Page" to begin filling out the form.
  • If you are an established patient who wants to update your contact or billing information, contact our Front Desk to get your personalized Registration Form pass-code.

Online Registration Forms - click here to complete them online

You may also download and complete physical copies of our patient form(s) prior to your appointment. Print the forms below to get started.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Required New Patient Forms


Patient History & Medical Questionnaire

Payment Policy

Payment Policy en español

Acknowledgment of Receipt of HIPPA

Acknowledgment of Receipt of HIPPA en español

Notice of Privacy Practice

Flu Season Policy

Consent Forms

Treat a Minor

Release of Medical Records

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