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  • CITRIX

Forms

New patient paperwork will be provided by the clinic when your new patient appointment is scheduled. Use the links below if you misplaced the provided forms, or need additional copies.

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Notice of Privacy Practices Notificación de Prácticas de Privacidad
Notice of Privacy Practices Signature Form Aviso de Reconcocimiento de Prácticas de Privacidad – formulario de firma
Patient Demographic Form Formulario Demográfico
Adult Medical History Form Antecedentes Médicos de Adultos
Adolescent Medical History Form Antecedentes Médicos de Adolescentes Entre 13 Y 18 Años
Child Medical History Form Antecedentes Médicos del Menor Hasta los 12 Años
Advance Consent to Treat Minor Antención Médica para Menores de Edad
Perpetual Authorization Form Autorización Permanente para Comprartir Información Médica Protegida (PHI)
Release of Information – From FCN to another facility/person Solicitud Saliente para Información Médica Protegida (PHI)
Release of Information – To FCN from another facility/person Solicitud Entrante para Información Médica Protegida (PHI)
Financial Policy

Patient Policies

Privacy Practices

Nondiscrimination & Language Assistance

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After Hours Contact

 

On-Demand Telemedicine for Urgent Care

Convenient virtual healthcare with an available FCN provider.

(video only)

Helpful Links

Contact Us

Lab Appointment

New patients

COVID-19

Nondiscrimination and Language Assistance Notices

Notice of Privacy Practices

Telemedicine

Terms & Conditions

Bellingham

Bellingham Bay Family Medicine

722 N. State Street

(360) 752-2865

Fax: (360) 647-8093

Chuckanut Family Medicine

1310 10th St., Suite 104

(360) 594-0592

Fax: (360) 526-2165

Family Health Associates

3500 Orchard Place

(360) 671-3900

Fax: (360) 647-0882

North Sound Family Medicine

2075 Barkley Boulevard, Suite 105

(360) 671-3345

Fax: (360) 650-1354

Sports Medicine

3130 Squalicum Parkway, Suite 110

(360) 756-0382

Fax: (360) 756-5184

Squalicum Family Medicine

3015 Squalicum Parkway, Suite 120

(360) 676-9336

Fax: (360) 575-2567

Urgent Care – Bellingham

3130 Squalicum Parkway

(360) 671-4509

Fax: (360) 756-5184

Whatcom Family Medicine

3015 Squalicum Parkway, Suite 160

(360) 671-4402

Fax: (360) 671-9463

Whatcom County

Birch Bay Family Medicine

8097 Harborview Rd.

(360) 371-5855

Fax: (360) 371-5857

Ferndale Family Medical Center

5580 Nordic Way

(360) 384-1511

Fax: (360) 384-5758

Lynden Family Medicine

1610 Grover Street, Suite D1

(360) 354-1333

Fax: (360) 354-5399

Urgent Care – Lynden

1610 Grover Street, Suite D1

(360) 354-4567

Fax: (360) 714-3146

Skagit County

Island Family Physicians

2511 M Avenue, Suite A

(360) 293-9813

Fax: (360) 299-8605

North Cascade Family Physicians

2116 E. Section Street

(360) 428-1700

Fax: (360) 848-4350

Urgent Care – Mount Vernon

205 Stewart Rd., Suite 104

(360) 395-2938

Fax: (360) 714-3147

Helpful Links

  • Contact Us
  • Lab Appointment
  • New patients
  • COVID-19
  • Nondiscrimination and Language Assistance Notices
  • Notice of Privacy Practices
  • Telemedicine
  • Terms & Conditions
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