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Our Forms

Here you will find all the necessary patient forms. Click on the title to view and print the forms. All the documents are in PDF (Adobe Acrobat) format. If you do not have Adobe Acrobat Reader installed on your computer, you can download the free reader directly from Adobe web site. See download link below.
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New Patient Paperwork

Please bring these forms with you to your first appointment.
Adult Information Packet
Pediatric Information Packet

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Incoming Record Request

Use this form to give your previous provider or provider's permission to send copies of your medical records to Tumwater Family Practice Clinic. If we receive those records before you have come in for an appointment to establish care with one of our providers, we will store the records for up to six months
Incoming Record Request

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Outgoing Record Request

Use this form to have copies of your medical records from TFPC sent to your new provider(s) office. If you want to have them sent directly to you, there will be a fee involved and our copy service will inform you of the amount before the records are copied.
Outgoing Record Request

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Email Records Request

Use this form to have copies of your medical records from TFPC emailed to you. Please bear in mind that our email is not encrypted so this has a degree of risk involved.
Email Record Request

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Health Risk Assessment Form for Annual Wellness Visit

 The TFPC Health Risk Assessment questionnaire is for patients covered with Medicare Part B whom scheduled their yearly Annual Wellness appointment for the year. This packet is normally mailed to you a couple weeks before your scheduled appointment. Feel free to print this packet and bring it your completed packet to your upcoming Annual Wellness appointment.
AWV Packet

Tumwater Family Practice Clinic
150 Dennis St SW Tumwater, WA 98501
Phone: 360-754-6367
Fax:360-754-6429

  • Home
  • About Us
    • Our Clinic
    • Our Providers
    • Clinic Policies
  • Patients
    • Appointments
    • Virtual Appointment
    • Services >
      • Our Services
      • Quest Laboratory
      • South Sound Radiology
    • Billing
    • Medical Records
    • Patient Portal
    • Privacy Practices
  • Forms
  • Contact
    • Map & Directions