CALL (360) 977-7815 FOR AN APPOINTMENT ~ OPEN MONDAY - FRIDAY 8AM TO 5PM

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OCCASIONALLY YOU MAY NEED TO MISS OR RESCHEDULE YOUR APPOINTMENT. WE’VE MADE IT EASY FOR YOU TO HANDLE THAT ON THE GO.

WE DO, HOWEVER, ASK THAT YOU GIVE US 24 HOURS NOTICE OF ANY CANCELLATIONS, SO THAT WE MAY OFFER THE OPENING IN THE SCHEDULE TO ANOTHER PATIENT.

ENTER YOUR INFORMATION IN THE FORM BELOW AND ONE OF OUR STAFF MEMBERS WILL CONTACT YOU WITHIN 24 HOURS TO CONFIRM YOUR REQUESTED RESCHEDULED APPOINTMENT TIME OR SPEAK TO YOU ABOUT SELECTING A SUITABLE ALTERNATIVE.

OF COURSE, YOU ARE ALWAYS WELCOME TO CALL AND RESCHEDULE IMMEDIATELY WITH US AT (360) 977-7815.

PLEASE NOTE: YOUR NEW APPOINTMENT IS NOT MADE UNTIL CONFIRMED BY OUR STAFF.

DATE OF APPOINTMENT

NAME

EMAIL ADDRESS

REQUESTED APPOINTMENT

NEW PATIENT?

PHONE NUMBER

REASON FOR APPOINTMENT

ESTABLISHED PATIENT?

OTHER COMMENTS