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Home › About Dr. Pujari › For Patients

Records Release Forms

Please forward relevant medical records prior to your appointment. Generally you should allow about three weeks for the records to arrive in our office. You may use the links below to download release forms from various local institutions or use our generic release form. Some links require the latest version of Adobe Reader®. If you have difficulty please use our generic forms.

  • Polyclinic Group Health 
  • Cooperative Harborview 
  • Medical Center Swedish Medical Center (all campuses) 
  • University of Washington Medical Center 
  • Virginia Mason Medical 
  • Center Generic Release (MS Word format) 
  • Generic Release (Adobe PDF format)

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Fremont Village Square. 3601 Fremont Ave N. Ste. 412, Seattle WA 98103. P: 206.344.8053. F: 206.344.7112

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