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New Patient Intake Form

For your first visit, please download the following three forms and bring the completed form with you. All forms must be completed before your appointment, or your appointment will be rescheduled.

Colorful Flowers

Women's New Patient

"Download All Forms (ZIP)" include the four files below. Individual downloads are available below.

  • FEMME CLINIQUE PATIENT INTAKE FORM Download 

  • FEMME CLINIQUE FEMALE PATIENT CONSENT HORMONE THERAPIES Download 

  • FEMME CLINIQUE PATIENT PAYMENT AGREEMENT Download 

  • Credit Card on File Billing Authorization Form Download

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Men's New Patient

"Download All Forms (ZIP)" include the four files below. Individual downloads are available below.

  • FEMME CLINIQUE PATIENT INTAKE FORM Download 

  • FEMME CLINIQUE MALE PATIENT CONSENT HORMONE THERAPIES Download 

  • FEMME CLINIQUE PATIENT PAYMENT AGREEMENT Download 

  • Credit Card on File Billing Authorization Form Download

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Hormone balance in just a few easy steps you can get started feeling great again

At your first visit, Dr. Kato will take time to understand your medical background and health history. After the first visit, lab tests can then be ordered to check your hormonal level. Based on your specific needs, Dr. Kato will recommend specific treatment and possibly additional lab testing. All efforts are here to help you increase your optimal health and reduce health risks. 

1

Call/Online

Call us at (425) 274-2777 with any questions, to schedule, or schedule your first visit online

2

Consulting

Meet with your doctor at our clinic in Bellevue to review your health concerns and treatment options

3

Treatment

Do some simple labs tests to determine your hormone levels and create a plan with your doctor

Office Hours

Map

Monday

Tuesday

Wednesday

Thursday

Friday

9 am - 4:30 pm

9 am - 4:30 pm

9 am - 1:30 pm

9 am - 4:30 pm

9 am - 4:30 pm

Contact Us (English and Japanese)

Thank you for your message

Femme Clinique
606 120th Ave NE Suite D104, Bellevue, WA 98005

Tel: (425) 274-2777 (English and Japanese)
Fax: (425)732-9919
Email: info@femmeclinique.com
カラフルなアジサイ

FEMME CLINIQUE

Bio-Identical Hormone Therapy Clinic Serving Seattle & Bellevue

© FEMME CLINIQUE 

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