Request Your Appointment 1Patient Information2Appointment Setup3Confirmation Your Name* First Last Date of Birth*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Mobile Phone Number*This is only used to confirm your appointment and send reminders. Appointment Location*Seattle Clinic Hours: Mondays (7am to 11am) and Wednesdays (7am to 2pm)Kirkland Clinic Hours: Tuesdays (7am to 3pm), Thursdays (6am to 3pm), and Fridays (8am to 3pm)Federal Way Clinic Hours: Mondays, Tuesdays, and Wednesdays (7:30am to 2pm)NOTE If you need assistance with scheduling please call (206) 960-4770, select option 1 ALERT We only accept new patients who reside in Washington, currently. Kirkland Federal Way Seattle Appointment Date Requested* MM slash DD slash YYYY Appointment Date Requested* MM slash DD slash YYYY Appointment Date Requested* MM slash DD slash YYYY Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 7:00AM 7:30AM 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 7:30AM 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM 11:00AM 11:30AM 12:00PM 12:30PM 1:00PM 1:30PM 2:00PM Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 7:30AM 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM 11:00AM 11:30AM 12:00PM 12:30PM 1:00PM 1:30PM 2:00PM Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 7:30AM 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM 11:00AM 11:30AM 12:00PM 12:30PM 1:00PM 1:30PM 2:00PM Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 7:00AM 7:30AM 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM 11:00AM 1:00PM 1:30PM 2:00PM Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 7:00AM 7:30AM 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM 11:00AM 1:00PM 1:30PM 2:00PM Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 6:00AM 6:30AM 7:00AM 7:30AM 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM 11:00AM 1:00PM 1:30PM 2:00PM Appointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AM 11:00AM 1:00PM 1:30PM 2:00PM HiddenUsername Your request is not complete until you select "submit" at the bottom of this page. {all_fields}We will contact you within 1-2 business days after form submission to confirm your request. We require a $95 pre-payment to reserve your appointment and is fully refundable if cancelled 24 hours prior to your confirmed appointment time.
