If you have made an appointment with Dana, please print the following forms and bring (completed) to your first appointment.

 

DISCLOSURE STATEMENT

 

INTAKE FORM

 

NOTICE OF PRIVACY PRACTICES

 

SOCIAL MEDIA AND TECHNOLOGY POLICY

 

 

 

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2366 Eastlake Ave E, Suite 225    
Seattle, WA  98102
Telephone:  206.419.0155
Email:  dkovalchick@msn.com