Patient Forms

Below are the most commonly-requested forms. If you’re a new patient preparing for your first visit at Bellingham Physical Therapy, feel free to print and complete the following forms from the comfort of your home: Patient Intake Form, Billing Information, Notice of Privacy Practices, Authorization to Speak to Others, and the Medicare Payment Authorization (if applicable).

Patient Intake Form
Download Form


Billing Information

Notice of Privacy Practices
Signature Form


Medicare Payment Authorization
Signature Form

Download Form



HIPAA Notice of
Privacy Practices
Download Form



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Phone: (360) 647-0444

306 36th Street Bellingham, WA 98225
(By the REI in Sehome Village)

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