Today's Hours: Monday 8:00 AM - 4:00 PM

For life-threatening emergencies such as active chest pain, please call 911.

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FORMS

Contact Information

General Inbox

360-716-4511

Patient Registration Email *

7520 Totem Beach Rd
Tulalip, WA 98271



* By utilizing this email address to send your registration documents and PII (Personal Identifiable Information) to the Tulalip Health Clinic Registration Team, you are releasing the information to the Tulalip Health Clinic Registration Staff in order to register you as a patient with our clinic. Please put in the email subject and in the body of the email “FOR OFFICIAL USE ONLY – PRIVACY SENSITIVE” Please also note that you will not receive a reply from this email address, as it is for documents only. For further assistance, please call 360-716-4511.

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Forms and Documents

COVID Vaccines

pdf icon Prevaccination Checklist for COVID-19 Vaccines

Employee Registration Form

pdf icon Employee Registration Form

Acknowledgment Of Paternity

pdf Acknowledgment of Paternity

Authorization For Treatment

pdf Authorization for Treatment

Behavioral Health

pdf Release of Information

Behavioral Health Chemical Dependency

pdf Case Specialist and Outreach Transportation Brochure

Behavioral Health Healing Lodge

pdf Healing Lodge Brochure

Community Health Prevention Education

pdf Quit Smoking Brochure

Consent Form For Minors

pdf Consent Form for Minors

Medical Care Podiatry

pdf Foot Care Tips

Npp Acknowledgment

pdf NPP Acknowledgment

Patient Registration Checklist

pdf Patient Registration Checklist

Tt Chs Verification Of Residency

pdf TT CHS Verification of Residency