Patient Policies & Responsibilities

Arrival time

Please plan to arrive at the time of the appointment, as shown in MyChart. If you are late arriving for your appointment, you may not be able to be seen.

Cancellation or Rescheduling

If you need to cancel or reschedule your appointment, you can do so through MyChart or by contacting us at 253-383-5777. Please make sure to notify us at least 24 hours in advance if you are unable to make it to an appointment.

To cancel via MyChart:
Go to MyChart, select Appointment, and tap on “Cancel appointment”, or
Go to MyChart and send a message to your provider letting them know you need to cancel

New patients

Patients are considered new patients if they have never been seen at a Pediatrics Northwest clinic or if they have not been seen by a clinician at Pediatrics Northwest within the prior 3 years. Pediatrics Northwest will not schedule appointments to establish care for new patients 18 years and older.

Missed Appointments, Late Arrivals and Cancellations

Thank you for trusting your medical care to Pediatrics Northwest, P.S. We strive to provide excellent medical care to you, your family, and all of our patients. In order to provide adequate time for each patient, appointments are scheduled taking into account the patient’s current needs.

If you miss your appointment, without notifying us at least 24 hours in advance, the time that was allotted for your visit cannot be used to treat another patient. In order to best serve all our patients, we ask that you follow our Medical Appointment Cancellation Policy.

Our Policy:

Please give our office at least 24-hour notice in the event that you need to reschedule your appointment. This will make the appointment time available to someone else. Our scheduling number is 253-383-5777 – Please call if you need to cancel or change your appointment.

A “no-show” is defined as missing a scheduled appointment. A patient/family may be dismissed from the practice if a patient has three total “no-shows” within a 12-month period.

Double appointments are defined as siblings/family members that are scheduled together in back-to-back appointments. If a family “no-shows” a double appointment, they will not be allowed to schedule another double appointment for the rest of the calendar year.

If you are late for an appointment, we will make every effort to see you, however:

• The office visit may need to be shortened in length
• You may need to see a different provider.
• The appointment may need to be rescheduled to the next available date.

Under Washington State law, minors have the right to consent to certain health care without a parent or guardian’s consent. A minor may consent to and obtain confidential medical care:  

• If the minor is emancipated (legally independent) or married to someone at or above age 18.  
• In the event emergency care is necessary.
• For birth control and pregnancy-related care at any age.
• For outpatient drug-and alcohol-abuse treatment beginning at age 13.
• For outpatient mental health treatment beginning at age 13.
• For sexually transmitted diseases, including HIV, beginning at age 14.   

During our adolescent well visits, our pediatricians will spend part of each visit alone with the patient. This is an opportunity for teens to become more comfortable speaking alone with their doctor, something that they will need to do independently once they become adults. We also want to give all teens an opportunity to address any and all of their healthcare concerns in a private and confidential manner, should they need or want to. When teens share something with us that they ask to remain confidential, we will honor that request, unless that information causes reasonable concern for a plan to harm themselves or someone else.  

Chlamydia is the most common reportable sexually transmitted infection. Due to the largely asymptomatic nature of Chlamydia and Gonorrhea infections, all patients 16 years and older, regardless of sexual history, will be screened for both chlamydia and gonorrhea at their annual well visit unless they opt out of the universal screening.  

If you would like your 16-17-year-old to be seen alone without a parent/guardian for a medical reason not listed above, you will need to have a signed consent on file. Please complete the Advance Consent to Treat Unaccompanied Minor (16+) form.  

Pediatrics Northwest is committed to providing safe, effective, and evidence-based medical and mental health care to the children and adolescents of the South Sound region and beyond. Somewhere between the ages of 18-21, our adolescent patients will leave Pediatrics Northwest and begin seeing providers who care for adults. We want our patients and their families to feel successful and supported in this transition from family-centered pediatric care to patient-centered adult care.  

 Once a patient turns 18, we must have a signed consent on file in order to discuss any of their health care with a parent/guardian. Please complete the Over 18 HIPAA Consent Form. 

 Patients are considered new patients if they have never been seen at a Pediatrics Northwest clinic or if they have not been seen by a clinician at Pediatrics Northwest within the prior 3 years. Pediatrics Northwest will not schedule appointments to establish care for new patients 18 years and older. 

Medication refill requests 

All refill requests will be processed within 3 business days of receipt. Requests must contain adequate information (pharmacy information and  medication being requested). If further guidance is required, then the 3 business day timeframe restarts. Refills will only be submitted if the patient has had a health screen (well child visit) within the last 12 months. If a refill cannot be completed, denial of the refill request will be communicated to the patient/family and the denial communication will include reason for the denial and what steps are needed to get the medication refilled. Patients need to be up to date on annual health screen and related medication visit. 

 Paperwork requests 

• It is the patient’s/guardian’s responsibility to know the deadline dates for school forms and other forms requested by employers or other programs. 
• Most requests for forms will be completed within 3 business days. Some forms that take longer to address, such as FMLA paperwork, may take up to 7 business days for completion.  
• See Immunization section for policy on vaccine exemption requests.  

 The following requests require an appointment with your primary care doctor:  

• Court paperwork for legal guardianship  
• International adoption paperwork  
• Military paperwork  
• Immigration letters  
• Dental pre-operative clearance, if the patient has not been seen for their well visit within 30 days of the procedure date.  

 Emotional support animal letter 

Pediatrics Northwest clinicians are unable to complete any “reasonable accommodations” forms or letters for emotional support animals. If you or your child is seen by a mental health professional who suggests the use of an emotional support animal to help alleviate a diagnosed medical condition, please coordinate with that provider for any needed accommodations. 

Pediatrics Northwest has a “zero tolerance” policy for disruptive behavior, which includes any behavior that makes it difficult for the care team to provide services. Disruptive behavior includes making discriminatory or threatening remarks to the care team or other patients and visitors. This policy protects all patients, families, visitors and Pediatrics Northwest employees and providers. I agree to report any disruptive behavior to my health care team and I will take all steps that I reasonably can to avoid participating in any disruptive behavior myself, or through any friends or family members. Individuals engaged in disruptive behavior may be precluded from calling, visiting or otherwise participating in my care. 

Vaccine exemption forms

Patients who decline vaccines will likely be required by their child’s school or daycare to have an exemption form signed. At Pediatrics Northwest, implementation of this policy requires that: 

• The form should typically be signed by the patient’s Primary Care Physician  

• The patient needs to be current on their well visits in order for this to be signed without a visit.  

• In Washington state, the law does not allow for personal belief exemption for MMR vaccine, only religious belief exemptions. 

• If a patient is not up to date on their well visits and has been seen within the last 2 years, they will be scheduled for one and a temporary Exemption Form will be signed with an expiration date for the date of the well visit. 

• Patients who have not been seen for the past 2 years must be seen before the Exemption Form is signed 

Vaccines and Medications for International Travel

If you are planning a trip outside of the United States and think you may need less common travel vaccines or medications, you should be seen at a travel clinic. Information about travel clinics and their resources can be found at the Tacoma-Pierce County Health Department website. 

Travel clinics offer international travel preparation and vaccinations to all members of the community – including children and adults – who are traveling abroad for leisure, mission trips, business, school trips, visiting friends and relatives, and adoption.