Email Referral Form


If this is an emergency, please dial 911 immediately.

The email requests below are not confidential or secure. If you are concerned about the privacy of your information, please contact our physician referral representative at (206) 444-8419.


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Insurance: *
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If you are unsure of the kind of provider you need, please call our physician referral representative at (206) 444 - 8419, Monday through Friday from 8:00 am to 4:30 pm.

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I would like to receive future updates or news from Highline Medical Center