Palouse Medical

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Established patients can access our patient portal to connect to health information and utilize our online services. Start using your portal today!

Palouse Medical’s Patient Paperwork & Forms

Complete the necessary paperwork for you next appointment ahead of time. You may choose to return the forms to our office by mail, fax, or can bring them to our office.


Getting started at Palouse Medical is as easy as 1, 2, 3!
Please open each of the following links and complete the forms.

Palouse Medical patient profile Palouse Medical health historyPalouse Medical privacy notice

Form #1: Patient Profile

  • Initially completed by ALL new patients, as it allows us to create your patient account.
  • Completed by ALL patients who have experienced a name change or have new contact information.

Form #2: Personal Health History

  • Initially completed by ALL new patients.
  • Completed (often annually) prior to complete physical examinations. 

 Form #3: Patient Privacy Notice

  • In compliance with HIPAA, this notice must be provided to ALL patients.
  • Please read this document prior to signing the privacy notice section on the patient profile.

Medical Records Authorizations

Below is our medical record authorization form. This allows us to help keep your medical records
current and managed as you are coordinating care with other offices, transferring from another clinic,
or if you need to send records from Palouse Medical or Pullman ReadyCare. To get started, simply click on the link below and a window with a PDF file containing the authorization you need.

Palouse Medical Records Requests

Our Release Form

This form authorizes us to request or release your medical records or personal health information to a designated individual or an external health care provider.


Important Notice:
we must obtain the signature of the individual(s) or legal guardian of the medical records Thank you for understanding and your cooperation.

Flex spending request


Flex Spending: OTC Reimbursement Request

This is Palouse Medical’s general form for patients to complete to receive reimbursement for Over-The-Counter (OTC) medical expenses from flex spending plans. Please check with your Flex Spending Plan administrator to verify that this form will work, as Palouse Medical can not guarantee that they will accept this generic form.






Call Us Today!

Main Office: 509-332-2517
ReadyCare: 509-332-8847

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From Our Patients

Don't take our word for it, read what our patients are saying:

I have nothing but good things to say about the doctors and nurses at Palouse Medical. Haven’t met all the staff, but the ones I have met are superb. Also, the two in the lab that draw my blood each Thursday a.m. are the best. The patient account lady in the billing office is so kind and understanding of our finances and works with us on payment schedule. Thank you Palouse Medical!

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