SBHC Appointment Request

Request an Appointment
School-Based Health Center

Students, if you're looking to schedule an appointment at the School-Based Health Center within Meadowdale High School or Mountlake Terrace High School, you're in the right place! Submit this form to request your appointment, but please note that it's just a request. We'll get back to you to confirm your slot. Or, if you prefer, give us a call at 425-835-5225, drop us an email at sbhc@chcsno.org. We're excited to see you soon!
Are you a registered patient of the CHC School-based Health Center?*

YesNoI don't know
Important Information About Minor Consent

Under Washington State law, youth may independently access reproductive health care at any age without parental/guardian consent. Youth (age 13 and older) may independently receive drug and alcohol services and mental health counseling without parent/guardian consent. Consent from the student is required to release information regarding their reproductive health, mental health (over 13), and/or substance use (over 13).

If you would like to access the above listed healthcare services without parental consent, and you are not a registered patient with the Health Center, please request an appointment using the form below.
Please request an appointment using the form below and someone from the Health Center will contact you about whether or not a patient registration form is on file.
Patient Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Contact Number:*
E-mail
example@example.com
Do you prefer a text, call, or email?*

TextCallEmail
What Type of Appointment are you Requesting?
What SBHC Location Would You Like to Schedule For?

Meadowdale HSMountlake Terrace HS
Request a Dental Appointment-Meadowdale
Request a Dental Appointment-MLT
Which vaccines do you need? (check all that apply)

MMRTdAPMeningococcalPolioHepatitis BHPVMeningococcal BI don't know/unsure
Preferred date/time or class period for appointment? *
Reason For Visit
Preferred Language
For help, email our support team at sbhc@chcsno.org
or call 425-835-5225.
Should be Empty:

Request an Appointment

School-Based Health Center