You can open and print any of the following forms to complete and return to your clinic in person or by fax or mail:
- Pediatric Registration (used at your child's first appointment)
- Authorization for Disclosure of Health Information (used to release your records to or from another office)
- Permission To Treat a Minor (used when a child under age 18 goes to the doctor without parent or guardian)
- MyChart Access Agreement (used to establish online access to your health information via MyChart)
Your role in your health care
Contact Information
Pediatric Specialty Care/Seattle
1101 MadisonFirst Hill Campus, Madison Tower, Suites 510 & 800
Seattle, WA 98104
Phone: 206-215-2700
Fax: 206-215-2702
8:30 a.m. - 5:00 p.m.
Sniffles, cough or tummy ache?
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