425-732-2677 | Schedule Appointment

Patient Forms

Please read the Patient Office Policy and the Privacy Policy prior to signing and completing the forms listed below. Please bring the completed forms with you to your first appointment.

Click to download: Signature Sheet

Click to download: Patient Intake Form

Click to download: HIPAA

Click to download: Cancellation Policy

Medical Release Form

It is very helpful for our providers to have information about your prior skin health history. Please download and fill out the “Medical Record Release Form” and send/fax it to your previous physician. Please call prior to your appointment to verify that we have received your records. This will enable our providers to provide you with the best possible care at the time of your visit. Thank you!

If you were a patient of Dr. Linnell’s at Pacific Dermatology & Cosmetic Center, fax the form to: 425.970.4565. Please call them at 206.859.5777 to make sure the form was received.

Click to download: Medical Release Form

If you need our records sent to another office, please download and fill out the form below.

Click to download: Medical Release Form

Skin Resurfacing Solutions
Fractional laser treatment can smooth the surface of your skin to offer you excellent results and a minimal downtime.
Lip Enhancement Solutions
Plumping up your lips is an easy way to improve your smile, whether your lips have thinned with age, or you’ve just always wished for fuller lips.
Darker Skin Solutions
I have the laser and cosmetic treatment know how to treat the unique challenges of patients with darker skin colors.
Bellevue Laser & Cosmetic Center