FORMS

For naturopathic medical attention, download the informed consent and pre-visit questionnaire forms.

Fill them out as completely as possible with a black pen, then mail the completed forms to 

Dr. Dodge at PO Box 772, Carnation WA 98014.

Please include a 10 dollar check made payable to Dr. Dodge to initiate the medical history taking process. 

Informed Consent.pdf (91.7 KB)

Patient pre-visit questionnaire.pdf (193 KB) 

Right Click and choose Save As... to download the form to your computer.

When the download is complete, select Open, to view the form.

All forms are provided in Adobe PDF format.

Adobe Reader is needed to view these files.

Adobe Reader is available as a free download.

Peter Dodge, N.D., M.S.

Office Location: 15435 Main Street NE, Duvall, WA

Mailing Address: P.O.Box 772, Carnation WA 98014

Phone: 425-941-6596