It is very helpful for Dr. Chiu 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.
If you need our records sent to another office, please download and fill out the form below.
Prior to your appointment please download and fill out the Insurance, Privacy Communication and HIPPA Forms below. Please call prior to your appointment to verify that we have received your records. This will enable Dr. Chiu to provide you with the best possible care at the time of your visit. Thank you!
If you were a patient of Dr. Chiu’s at Pacific Dermatology & Cosmetic Center, fax the form to:
Please call them at 206.859.5777 to make sure the form was received.