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New Patient Intake Form

For your first visit, please download the following three forms and bring the completed form with you.

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Women's New Patient

  • FEMME CLINIQUE PATIENT INTAKE FORM Download 

  • FEMME CLINIQUE FEMALE PATIENT CONSENT HORMONE THERAPIES Download 

  • FEMME CLINIQUE PATIENT PAYMENT AGREEMENT Download 

  • Credit Card on File Billing Authorization Form Download

View Synonyms and Definitions

Men's New Patient

  • FEMME CLINIQUE PATIENT INTAKE FORM Download 

  • FEMME CLINIQUE MALE PATIENT CONSENT HORMONE THERAPIES Download 

  • FEMME CLINIQUE PATIENT PAYMENT AGREEMENT Download 

  • Credit Card on File Billing Authorization Form Download

View Synonyms and Definitions

Hormone balance in just a few easy steps you can get started feeling young again

Your physician can help you determine how best to balance your hormones to increase your wellness and reduce your health risks. Becoming a patient is easy and your first visit includes labs and thorough review of your top health concerns and health history. Based on your specific needs your physician will recommend specific treatments and possibly additional lab testing. Our services are concierge so we invite you to contact us with any questions or concerns throughout the process.

1

Call/Online

Call us at (425) 274-2777 with any questions, to schedule, or schedule your first visit online

2

Consulting

Meet with your doctor at our clinic in Bellevue to review your health concerns and treatment options

3

Treatment

Do some simple labs tests to determine your hormone levels and create a plan with your doctor

Contact Us (English and Japanese)

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Map

1900 116th Ave NE, #200, Bellevue, WA 98004
Tel: (425) 274-2777 (English and Japanese)
Fax: (425)732-9919
Email: info@femmeclinique.com
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FEMME CLINIQUE

Bio-Identical Hormone Therapy Clinic Serving Seattle & Bellevue

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