On-Line Appointments for New and Return Patients

 

Regarding Appointments On Line

We feel this service will help our patients who are busy (work, kids, family, etc.) and do not have the time to sit down and make a phone call.  We know our phones are busy - and sometimes we have to place you on hold.   This site gives you the opportunity to request your appointment - at your convenience

Please read the following guidelines:

Do not use this form for urgent or emergency medical problems.

If you are experiencing a life threatening emergency, please call 911.  If you are a patient experiencing a non-life threatening emergency, please call.  Do not rely on an e-mail message!

Your appointment request (e-mail message) is sent to our clinic via the internet. Although we feel confident your messages to our clinic are secure,  the internet offers no absolute guarantee of confidentiality in regard to e-mail.  Please consider this fact when sending sensitive information

Remember  -  some employers may monitor e-mail you send or receive while at work

Your e-mail messages are received by our business office; printed  and referred to the appropriate staff person.  Appointments are made by the business office staff

Our goal is to respond to your e-mail within  24 - 48 hours after receipt.  If you do not hear back from our office within 24 hours, please call.  Remember, we are not open evenings or  weekends

 

Appointment Request Information

Please enter the following information.  Your message will be e-mailed to Valley Women's Clinic immediately upon pushing the SUBMIT button!  If you are concerned about the confidentiality of your message, you may want to use the old fashioned method and call our office!

Renton Office	(425) 228-0722
Covington Office	(253) 630-3644

 

We need the following information to make your appointment:

 By placing my initials in this box, I acknowledge that I have read and understand the above           warning regarding the use of e-mail to request a medical appointment
 

Please fill in all of the fields below!

Your Name:
Are you a new or returning patient?  New Patient - this will be my first visit Return Patient - I have been seen within the past two years Return Patient - I have not been in for at least two years
E-mail Address
Daytime Phone
Home Phone
Street Address
City, State Zip
Date of Birth
Name of Insurance

Which provider would you prefer to see? Tammy Sleeter, MD James Rice, MD Heather Kipa-Joseph, DO Anthony Tagavilla, MD Pat Crevensten, ARNP Barbara Golay, ARNP

..At which office? Renton Office Covington Office

Reason for your appointment?

 Date and Time you prefer?

Our goal is to e-mail you back within 24 hours.
We do not read our e-mail during weekends.

If you do not hear back from us within that time,
please call our Renton office at (425) 228-0722.
Our server may be down!