Massage therapy and activator method adjustment
Massage therapy and activator method adjustment
Panacea Natural Medicine
Panacea Natural Medicine

Patient Forms

Want to save time during your visit with us? Please print and fill out the following forms and bring with you on your first appointment.

Patient Information form
PNM Patient Information Form.doc
Microsoft Word document [310.5 KB]
Consent to treat
PNM Consent to treat.doc
Microsoft Word document [306.5 KB]
Patient intake form
PNM Patient intake.doc
Microsoft Word document [338.0 KB]

Don't forget to bring your insurance information with you.

In order to register and treat you promptly, we request that patients bring current insurance information with them for each visit.

Insurance Billing athorization
Insurance athorization form.doc
Microsoft Word document [27.0 KB]
Medical information release
If you have other medical information that you think we should have, please fill out this form so we can request this information from your other providers.
PNM Auth to Release Info.doc
Microsoft Word document [34.0 KB]

We accept most types of health insurance. Please contact us for further details.

Important telephone numbers for in case of emergencies:

Issaquah Swedish Hospital 425-313-4000
Emergency Services & Fire Department 911
Centers for Disease Control and Prevention 800-CDC-INFO (800-232-4636)
   
   
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© Panacea Natural Medicine

To Schedule in Issaquah:

Online scheduling

Panacea Natural Medicine

Dr. Patti Mullen, ND, LMP

 

Located In: Issaquah Wellness Center

1505 NW Gilman Blvd

Suite #3

Issaquah, WA 98027

 

Phone: (425) 590-7684

Fax:     (206) 892-9672

Email: Dr.Patti

 

Or use our contact form.

 

Located in: Vitality Chiropractic

410 Bellevue Way SE

Suite #202

Belleuve, WA 98004

 

To make an appointment: 

Phone: (425) 641-0555

To Schedule in Bellevue:

Online scheduling

Office Hours

Available by appointment only:

Monday through friday: 10am-5:00pm

 

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