Patient Forms

Medical History Form
Patient Admission Form

Click on the forms and print them directly from your internet browser window. Fill the forms completely with all your information and bring them to the clinic.

Courtesy Dosing Form

While you’re away from your treatment clinic, You can receive your dose at one of our MAT clinics by filling out the above form.

NWIH provides methadone at the following three clinics:

  • 3727 South Tacoma Way, Tacoma, WA 98409 / Phone: 253-300-7474
  • 9720 South Tacoma Way, Lakewood, WA 98499 / Phone: 253-503-3666