Printable forms

For your convenience, common patient forms can be viewed or printed in advance of your visit.

If you want to get a copy of your medical records fill out this form.

Patients of Ben Kuharich, DO

Helpful links

Click on the topics below to find out more from the Orthopaedic connection website of

This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopedic advice or assistance should consult his or her orthopedic surgeon.

 Salmon Medical Center
(360) 830-1100


  • Bring your insurance card or medical coupon
  • Bring your photo identification
  • Depending on your insurance plan, be prepared to make your co-payment during the registration process
  • Bring a list of your current medications or your prescription bottles
  • Please call if you are unable to keep your scheduled appointment. We request 24 hour notification. We will be glad to reschedule a time that works for you.