Patient forms
Forms and information in one convenient location
The information you provide on our forms will help us to get to know you better and will give you a better idea of what to expect before, during, and after your procedure.
General
+Surgery
+Aesthetic
+Notices
COVID-19
We are open and committed to keeping you and our staff healthy.
Optum Plastic Surgery Center is taking the spread of COVID-19 very seriously. COVID-19 is impacting how we all live, work, and stay healthy. There is a lot of information about this virus, often changing rapidly. We’re here to help you navigate this crisis and help keep you and your family healthy. In accordance with public health guidance, we’ve made some important changes to our clinic and surgical operations to keep you and our staff safe.
Kaiser Patients
There are changes to the US Anesthesia Partners-Washington Contract with Kaiser.
The Optum Plastic Surgery Center uses US Anesthesia Partners (USAP) to provide anesthesia services at our Surgery Center. The Optum Plastic Surgery Center understands that USAP is out-of-network with Kaiser as of March 1, 2021, so please ask your insurer if or how this might affect your coverage.
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The Polyclinic, PLLC d/b/a Optum Care Washington
The Polyclinic d/b/a Optum Care Washington is a physician owned and led practices having complete authority for all medical decision-making and patient care through their physicians and other licensed professionals. Optum, through its management organizations (“Optum”) provides non-clinical administrative services to support the Practices and their physicians. Neither Optum nor its management companies employs, engages, or supervises physicians or other licensed professionals, or determines or sets the methods, standards, or conduct of the practice of medicine or exercise of medical judgment or health care provided by the Practices or by any of their licensed professionals.