NEWS l AMHARIC l CHINESE l VIETNAMESE l KOREAN
HOME ABOUT US CHIROPRACTIC MASSAGE THERAPY NEW PATIENT CONTACT US
Dynamic Tree Menu by Vista-Buttons.com v5.0.0




Content on this page requires a newer version of Adobe Flash Player.

Get Adobe Flash player





The fastest and easiest way to schedule your appointment with the doctor is to fill out the form below, and one of our staff members will promptly schedule you with a convenient time to see the doctor. For your convenience we also have an office map and directions available for you to print out. Please don't delay as the majority of health conditions tend to worsen or recur without the appropriate care.

Appointment:

Seattle: 206-721-7200
Lynnwood: 425-214-1900

Patients may complete this form and then confirm with the receptionists before coming into the office.

Patient Name
Phone Number

###		-
###		-
####
Patient Email
Type of Health Insurance
 None 
 Not listed here 
 HMO 
 PPO 
 POS 
 IPO 
 EPO 
Select Physician
First Choice Date/Time

MM		/
DD		/
YYYY
HH		:
MM
AM/PM
Second Choice Date/Time

MM		/
DD		/
YYYY
HH		:
MM
AM/PM
Reason for visit. If this is an emergency, call 911


   Office Hours  l  Monday thru Friday   9:00 am - 7:00 pm   Saturday   10:00 am - 2:00 pm
   To make an appointment  l  Seattle 206.721.7200    Lynnwood 425.214.1900