Foster Wellness
4300 36th Ave W., #130
Seattle, WA 98199
206.856.4096
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    • Greg Lewerenz
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Forms

Book Appointment
Intake
Once you set up your first visit via the online scheduling system (see "Book Appointment" button above), you will be sent a link to complete the appropriate form(s) prior to your visit.  If you are unable to access the online forms, or if you do not receive the link after signing up for your first visit, please contact Greg to either have the link resent or make arrangements to arrive 5-10 minutes early to complete once you arrive.
Insurance
Please complete the "Acupuncture" and "Massage" forms below to obtain a complete picture of your possible benefits (unless you are only coming in for one service or the other).  Note that massage is only for Washington State Labor & Industry claims or Personal Injury Protection (PIP) motor vehicle accident claims.
  • Acupuncture/East Asian medicine insurance verification form
  • Massage insurance verification form

Privacy Practices
Foster Wellness takes your personal and medical privacy very seriously, as documented in our Privacy Notice.  This Privacy Notice is included with all intake forms and is also available as a separate document by clicking the link below.
  • Foster Wellness Privacy Notice
© 2008 - 2019
Foster Wellness 4300 36th Ave. W, Suite 130, Seattle, WA 98199
Phone: 206.856.4096 (Please note: this is a landline and cannot receive text messages)
Fax: 206.267.9491
 

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