dr. Geoff Lecovin
dr. Geoff Lecovin
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    • Chiropractic
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  • Articles & Blog
  • Contact Us
    • Home
    • About Us
    • Services
      • Naturopathic Medicine
      • Chiropractic
      • Acupuncture
      • Corrective Exercises
      • Performance Nutrition
    • Patients
      • Patient Forms
      • Online Payments
      • Online Scheduling
    • Articles & Blog
    • Contact Us
  • Home
  • About Us
  • Articles & Blog
  • Contact Us
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Patients

Patient forms

Print out and bring all forms to your appointment or fax to (425) 999-4484. We do not accept these forms via standard email due to HIPPA privacy requirements.

Contact Dr. Lecovin

NEW PATIENTS

Patient Registration (pdf)

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Patient Health History (pdf)

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Financial Policy (pdf)

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Insurance Benefits (pdf)

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Informed Consent (pdf)

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Privacy Practices (pdf)

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Acupuncture Patients

Patient Registration (pdf)

Download

Patient Health History (pdf)

Download

Financial Policy (pdf)

Download

Insurance Benefits (pdf)

Download

Informed Consent (pdf)

Download

Privacy Practices (pdf)

Download

Acupucture - Notification (pdf)

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Acupuncture - Waiver (pdf)

Download

#eatmove&performbetter

Contact Us

Dr. Geoff Lecovin

425.999.4484

staff@drgeofflecovin.com


284 Central Way

Kirkland, WA 98033

Hours

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