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    • Home
    • Services
    • About Us
    • INSURANCE INFORMATION
    • NEW PATIENT FORMS
    • Patient Portal
    • Contact Us
  • Home
  • Services
  • About Us
  • INSURANCE INFORMATION
  • NEW PATIENT FORMS
  • Patient Portal
  • Contact Us

Apple A Day
Family Medicine

Apple A Day Family MedicineApple A Day Family MedicineApple A Day Family Medicine

WHERE YOU SEE THE DOCTOR EVERY TIME.... BECAUSE IT MATTERS.

WHERE YOU SEE THE DOCTOR EVERY TIME.... BECAUSE IT MATTERS.WHERE YOU SEE THE DOCTOR EVERY TIME.... BECAUSE IT MATTERS.

New Patient Forms

 If you are a new patient to the practice, please take a moment to fill out the below forms (Patient Registration, Health History Questionnaire, and Financial Policy).  Please bring the completed forms with you to your first appointment. 

If you don't have access to a printer, no problem.  We've got plenty of copies in the office and you can fill them out prior to your appointment. Please make sure to arrive at least 15 minutes early. 

Patient Registration Form (pdf)

Download

Health History Questionnaire (pdf)

Download

Financial Policy (pdf)

Download

Privacy Policy (pdf)

Download

Records Request Form (pdf)

Download

Apple A Day Family Medicine

1205 SE Professional Mall Blvd, STE 105, Pullman, WA 99163

(509) 332-2400 - phone (509) 332-2402 - fax

Copyright © 2022 Apple A Day Family Medicine - All Rights Reserved.

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