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PATIENT FORMS & POLICY

PATIENT PORTAL

If you need to:

  • Schedule appointments online
  • Renew your medications
  • Ask us a question
  • Receive secure messages from our practice

Please visit our Patient Portal or call our office at (425) 576-1700.

FORMS

Patient Information Sheet

Medical Information

Release of Medical Records

Advanced consent to treat minors

Allergy test prep instructions

NW Face Allergy history form

NW ENT Allergy history form

NW Face Allergy Immunotherapy Consent Form

NW ENT Allergy Immunotherapy Consent Form

Portal Enrollment Process

No Show Policy

PAYMENT

Our clinic accepts the following forms of payment:

  • Visa
  • Mastercard
  • American Express
  • Discover
  • Personal check
  • Cash

All Cosmetic fees and copays are due at the time of service. Copays not paid at the time of service are subject to a $25.00 late fee.

Coupons and Gift Certificates must be presented at time of service to be valid

Reminder to insurance patients: A coverage determination, prior authorization, or certification that is made prior to a service being performed is not a promise to pay for the service at any particular rate or amount. The patient’s summary plan description governs amount payable, as every claim submitted is subject to all plan provisions, including, but not limited to, eligibility requirements, exclusions, limitations, and applicable state mandates.

ETIQUETTE

In order that Northwest Face may provide all clients with the very best of care, please respect the following policies:

  • Please maintain conversations at a considerate volume
  • Please turn off all pagers and cell phones
  • No pets, please
  • All minors must be accompanied by an adult

LATE ARRIVALS AND CANCELLATIONS

Appointments have been designed to allow the appropriate time for the extent of your service. Your late arrival may limit our ability to offer the fullest experience possible.

We understand that sometimes it is necessary to re-schedule appointments. We ask that you give at least 24 hours notice prior to canceling and we will gladly reschedule your appointment. In the event that you are unable to give sufficient notice, a $50 cancellation fee may apply. We regret any inconvenience this may cause.

GIFT CARDS

Gift Cards are a memorable expression of caring, from the unique presentation to the exquisite experience. Cards are available in any denomination and may be applied towards all products and services, including cosmetic surgery.

If you are a recipient of a donated or auctioned Gift Certificate, please give our receptionist the certificate number to book your appointment. Donation certificates are non-transferable, and their expiration dates may not be changed or extended.

PARKING

Parking is available in self-paid lots. We regret that we are unable to validate parking.

DIRECTIONS

Get directions to our offices here




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