GOLFLETICA Sports and Rehab

Patient Intake Form

***BEFORE COMPLETING THIS NEW PATIENT INTAKE, YOU MUST CONTACT THE CLINIC DIRECTLY TO SCHEDULE AN APPOINTMENT (PHONE: 425-221-7253)**** Welcome to our online Patient Intake Form. The information you fill in will be sent directly to our office, speeding up your office visit and allowing us to better serve your healthcare needs.

Who are you?