Appointment Request

Appointment Request (version-6)

*For your Protected Healthcare Information (PHI), please do not include any medical information in the space below.

If you have coverage through Premera or Regence, please take the time prior to scheduling to verify that you are covered by a PPO Plan. Recently there have been significant changes to some Premera & Regence products that may limit access to our providers.

American Academy of DermatologyAmerican Board of DermatologyAmerican Medical AssociationThe International Society For The Study Of Vulvovaginal DiseaseNational Vulvodynia AssociationWashington Dermatology AssociationWomen's Dermatologic Society
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