Fisher's Landing Urgent & Family Care Patient Forms
Please down load the needed forms and have them filled out prior to your appointment.
Fisher's Landing Urgent & Family Care Forms
- Patient Registration Form
- Patient Responsibility Form
- HIPPA - Disclosure of Usage of Medical Records
- Patient Medical History
- Prescription Refill Policy
- Prescription Refill Tips
- Authorization to Release Medical Information
Fishers Landing Urgent and Family Care Clinic is a Preferred Provider for the following Insurance Companies. We are adding new insurances periodically. If you do not see your plan listed, please call or email us to inquire or check with your insurance carrier for coverage.
- Aetna
- Ameriplan
- Cigna
- CCN
- Department of Health
Early Intervention Plan - DSHS
- First Choice Health
- First Health
- Great West
- Health Care Direct
- Health Net
- Humana
- Integrated Health Plan
- Labor & Industries
- Medicare
- Multiplan
- National Choice Care
- ODS
- Pacificare
- Premara BlueCross
- Providence Health Plans
- Providence Preferred PPO
- Regence BlueCross/BlueShield
- Tricare
- United Healthcare
- Most Auto Insurance Carriers
(for motor vehicle accidents)