Patient Forms

At your first appointment at Bastyr University Clinic, you will be asked to complete a patient information form and health history. It is helpful if you bring along copies of previous tests, lab results and the names of any medications or natural supplements you are currently taking. You can also save time by sending the completed forms in advance of your first visit by downloading them, completing the forms and then:

  • Faxing them to the clinic at (858) 246-9710
  • Mailing them to the clinic: Bastyr University Clinic, 4110 Sorrento Valley Blvd., San Diego, CA 92121
  • Downloading the forms into your MyChart account.

Download and print the PDF documents below (Download free Adobe Reader software):

Additional Forms

A parent/legal guardian must attend a minor’s first visit with Bastyr University Clinic. For parents or legal guardians who cannot be present for subsequent visits, please fill out this form: Permission to Treat a Minor Without a Parent/Guardian Present.