1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon

Contact Us

The Seattle Facial Plastic Surgery Center
1101 Madison Street, #1280
Seattle, Wa. 98104

Tel:(206) 624-9113
Fax:(206) 624-0244

Patient Forms

  • Click the link on the left to print a form directly from your web browser, or
  • Click the icon to download the Adobe Acrobat* version of the form.

intake form Patient Registration Form
system review System Review
privacy policy Acknowledgment of Privacy Practices
patient medical information Patient Medical Information
consent form Consent of Non-Secure Forms of Electronic Communication

Special Financing

plastic surgery financing

* This requires Acrobat Reader or its browser plug in, which most current web browsers have pre-installed. If your browser does not have Acrobat Reader, you can get it for free; visit to download the software.

Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self