- Patients or parents/legal guardians fill out this form (PDF).
- Send the form to Health Information Management:
- Mail or deliver:
- Health Information Management
Odessa Brown Children’s Clinic
2101 E. Yesler Way, Suite 100
Seattle, WA 98122
If you have questions, please call 206-987-7209, Monday–Friday, 8 a.m. to 5 p.m.