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Click the “Schedule It” button below to consent to care; acknowledge receipt of our Joint Notice of Privacy Practices and Patient Rights and Responsibilities; agree to financial responsibility for the visit; and confirm your appointment.

By confirming and scheduling online you are consenting to the following terms as the patient or surrogate decision maker for the patient, including minors, as defined on the Care Agreement form below. If you have questions, please do not click the “Schedule It” button and instead call 206.520.5000 to schedule.

1. UW Medicine Care Agreement - This is a Care Agreement. By continuing to scheduling online, you are consenting to this form and thereby giving UW Medicine providers consent to treat you, keep images related to your care, and to receive care via telemedicine technology. You also acknowledge that the benefits, risks, and alternatives have been reviewed with you.
2. UW Medicine Joint Notice of Privacy Practices (NOPP) and Acknowledgement - We have the responsibility to protect the privacy of your information. The purpose of this form is to inform you of your rights as a patient here.
3. Patient Rights and Responsibilities - This information helps ensure that patients and their families are aware of their rights and responsibilities, and have the information that will allow them to protect their dignity and independence.
4. UW Medicine Financial Agreement & Acknowledgement - This is a Financial Agreement and by continuing to scheduling online, you are consenting to this form and are giving UW Medicine permission to bill your insurance company.

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