Due to a measles case in the community, please call before coming to Seattle Children’s if you or your child has potential measles symptoms.

Urgent Care Clinics

Urgent Care Cancellation Form

Please provide as much information as possible.

Urgent Care Location

Appointment Date / Time

Name of person who requested the appointment/cancellation

* First Name

* Last Name

* Patient Name

Patient Date of Birth

Please provide the following information so that we may confirm your cancellation. Thank you.

* Email Address

Phone Number

Reason For Cancellation

If Other selected above, please specify reason:

4800 Sand Point Way NE,

Seattle,

98105

206-987-2000

866-987-2000 (toll-free)

206-987-0391 (TTY)

Seattle Children’s complies with applicable federal and other civil rights laws and does not discriminate, exclude people or treat them differently based on race, color, religion (creed), sex, gender identity or expression, sexual orientation, national origin (ancestry), age, disability, or any other status protected by applicable federal, state or local law. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.

Urgent Care Cancellation Form

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