(509) 332-3548 | After Hours: (208) 883-5036 | 915 NE Valley Rd. (Near WSU)
OFFICE HOURS: Monday through Thursday - 7:30 am to 8:00 pm
Friday 7:30 am to 5:00 pm, Saturday 8:00 to 12:00 noon

 
  Request An Appointment Adjust Font Size  

To request an appointment online, please complete your request below. Someone from our office will be in touch with you soon. Our goal is to respond to your request within 24 hours, however, please allow up to 48 hours, excluding weekends and holidays. If you have not heard from our office within 2 business days, please contact our office at 509-332-3548. 

If you are experiencing chest pain, shortness of breath, severe pain or bleeding, an allergic reaction, or any other emergent or potentially life threatening symptom, please contact 9-1-1 or go to your local emergency room.  It is NOT appropriate to utilize an online appointment request in these circumstances.

 

All fields are required.

PATIENT INFORMATION

First Name:

Last Name:

Middle Initial:

Date of Birth:

Gender:

Male     Female

Street Address:

Street Address 2:

City / State / Zip:
Daytime Phone:
Evening Phone:
E-mail:
How did you hear about us?
APPOINTMENT INFORMATION
Reason for appointment:
Patient Status:
Preferred Day: (choose 3)
Preferred Time:
Type of Insurance:
Primary Healthcare Provider:
Requested Provider:  (View Schedule)



 

PullmanFamilyMed.com | (509) 332-3548 | After Hours: (208) 883-5036 | Fax: (509) 332-5253 | 915 NE Valley Road (Near WSU) | Pullman, WA 99163