​

Forms, Contact Info, and Tax ID

​

Appointment Request Form

​

Please go the "Appointment Request" tab to access this form

​​

 

Release of Information

​

A simple, on-screen form can be completed to direct another party to share information with your clinician, or for your clinician to share information with another party.

​​

Check all the boxes that might apply regarding the nature and purpose of the information you wish to be shared.  Use your mouse (or finger, if a touch screen) to sign.  Usually, you will pick an ending date within a year of the start date.  Once submitted, our staff will receive it and upload it directly to your electronic file.

​

Click on the below link to access this form:

​

https://form.jotform.com/232154609749059

​​

​​

Contacting NWPR or Your Clinician

​​

NWPR Main Phone:  360-414-8600 x0

NWPR Fax: 360-636-7372

​​​

The telephone extension of your clinician can be found by calling the main office and listening to the provider directory, or on your clinician's Provider Info page.

​​

Clinicians make their own policies about providing e-mail access to the public and other agencies.  From the Provider Info tab, please refer to the biography section for the clinician (accessible from the front page photo of the clinician) to see if they have provided a personal e-mail address.  E-mail communication should not be considered confidential, and we encourage you to contact us by phone or fax if you require a higher level of privacy.  Directly e-mailing your clinician assumes you understand the risks to your privacy.  In most cases, clinicians also maintain encrypted services they can share with you. 

​

After being invited and creating your personal account, you may also send and receive secure messages through our patient portal system. 

​​

​ 

NWPR Tax ID

​

NWPR is the revenue receiving and distributing agency for independent contractor clinicians. 

The IRS Tax Identification Number for Northwest Psychological Resources, LLC is 91-1854138.

​​