If you would like additional information about our clinic, our pediatric trials, or to schedule an appointment for an evaluation, you can complete the questionnaire and a staff member will contact you. You may also call our office at  877-453-0404.

 

Address                                           Clinic Hours
1951 152nd Pl NE                             Monday  &  Thursday:   7:30am – 4:30pm
Suite 200                                          Tuesday & Wednesday: 8:30am – 7:30pm
Bellevue, WA 98007                         Friday:  CLOSED

Phone Number                               Email
Local:         (425) 453-0404              Use the form on the right to send us a message.
Toll Free:   (877) 453-0404
Fax:            (425) 453-1033

 

Contact us by phone 24 hours a day, 7 days a week.


View Larger Map

General Driving Directions:
From I-405 head east on SR 520 to the 148th Ave NE exit southbound.
Head south to the 3rd traffic light and turn left (East) on 20th Ave NE.
The next light is Bel-Red road. Continue on 20th Ave NE just past the light there is a driveway on the right.
Parking is at the rear of the building.


Questionnaire:

Complete the questionnaire below and someone from our office will contact you to with more information about the clinical trial.


Do you experience any of the following symptoms? (Please check all that apply)

 Dull, burning, or sharp pain Pain in a single point in your back Pain over a broad area Pain that occurs gradually or suddenly Pain in your legs, such as numbness or tingling

Are you currently taking medication for your pain?
 Yes No

If so, what medication(s) are you taking?

Do you have a history of any of the following?

 Seizure Disorder Stroke Head Injury Brain Tumor Cancer NONE

What is your Gender?
 Male Female

Are you over 18?
 Yes No

Your Name (First and Last):

Phone:

Email Address:

Zip Code:

What is the best time to contact you?

How did you hear about us?
 Referral Flyer/Brochure Radio TV Web Advertisement Internet Search Facebook Previous Patient

Please enter any questions or comments in the space below.

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