Request Your Appointment1 Patient Information2 Appointment Setup3 ConfirmationYour Name* First Last Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Mobile Phone Number*This is only used to confirm your appointment.Last 4 of Social Security NumberThis will be used to verify your identity and give access to our secure online patient portal.Health InsuranceWe accept most insurance. Enter your insurance (optional)Please Select Your Health InsurancePlease note we do NOT accept Medicare or Medicaid.PremeraBlue Cross Blue ShieldRegenceUnited HealthcareAetnaLifewiseFirst ChoiceKaiser PermanentGroup IDMember IDAppointment Location*Seattle Clinic Hours: Mondays (8am to 11am), Wednesdays (8am to 2pm), Saturdays (8am to 10am)Kirkland Clinic Hours: Mondays (1pm to 3pm), Tuesdays (8am to 3pm), Thursdays (8am to 3pm), Fridays (8am to 3pm), Saturdays (Noon to 3pm)Federal Way Clinic Hours: Tuesdays, Wednesdays, and Thursdays (7:30am to 2pm)NOTE If you assistance with scheduling please call (206) 960-4770, select option 1SeattleKirklandFederal WayAppointment Date Requested*Date Format: MM slash DD slash YYYY Appointment Date Requested*Date Format: MM slash DD slash YYYY Appointment Date Requested*Date Format: 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. 8:00AM 8:30AM 9:00AM 9:30AM 10:00AM 10:30AMAppointment 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 2:00PMAppointment 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 2:00PMAppointment 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 2:00PMAppointment 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 9:30AMAppointment 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 2:00PMAppointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 1:00PM 1:30PM 2:00PMAppointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 1:00PM 1:30PM 2:00PMAppointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 1:00PM 1:30PM 2:00PMAppointment 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 2:00PMAppointment 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 2:00PMAppointment 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 2:00PMAppointment Time RequestedThe following appointment times are generally available but our staff will call you to confirm your appointment after your request has been submitted. 1:00PM 1:30PM 2:00PMUsername Your request is not complete until you select "submit" at the bottom of this page.{all_fields}Additional Options Send me email updates once in a while. Add me as a user to this website.
