Patient Forms
**As of 3/10/23, we are ONLY accepting new patients for adult HIV care. For HIV care, please submit this form before scheduling an appointment for the first time. For those seeking other care, we apologize for the inconvenience and will update our website and Facebook page when this changes.**
Please submit this form only after we have instructed you to do so.
Here at VECTOR Health & Wellness, we know that you are much more than the medications you take or the diagnoses you carry. There are a lot of factors that contribute to your health. We ask the questions most other medical providers skip - because the nosy questions matter too! Please complete this questionnaire in preparation for your new patient appointment as completely as you are comfortable. If you have any questions about this form, please complete what you can and ask your provider any questions during your visit.
Please submit this form only after we have instructed you to do so.
Print this form and complete ONLY THE HIGHLIGHTED SECTIONS so VECTOR can OBTAIN medical records FROM another provider. Please only complete the highlighted portions or we will have to void the document and have you complete a new one. Once you have completed the document, you can email it to info@vectorhealthnwa.com or bring it in person to the clinic. Once received, we may reach out to assure we have completed the rest of the form correctly.
Print this form and complete ONLY THE HIGHLIGHTED SECTIONS so VECTOR can SEND medical records TO another provider. Please only complete the highlighted portions or we will have to void the document and have you complete a new one. Once you have completed the document, you can email it to info@vectorhealthnwa.com or bring it in person to the clinic. Once received, we may reach out to assure we have completed the rest of the form correctly. **PLEASE NOTE: VECTOR cannot re-release some or all of the records we have obtained from other providers.**