Upload Lab Results

Please upload your lab results using the form below

The Records Release Form expires every 90 days. If it has been 90 days or more since you last completed this form, please fill out a new one below.

New/Returning Patient - Records Release

    • Date Format: MM slash DD slash YYYY
  • Definition
    • Sexually Transmitted Disease (STD) as defined by law, RCW 70.24 et seq., includes herpes, herpes simplex, human papilloma virus, wart, genital wart, condyloma, Chlamydia, non specific urethritis, syphilis, VDRL, chancroid, lymphogranuloma venereuem, HIV (Human Immunodeficiency Virus), AIDS (Acquired Immunodeficiency Syndrome), and gonorrhea.

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