All information is strictly confidential with the following exceptions:

  • When you give me written permission to release the information to a person or an institution
  • When legal and ethical responsibilities require me to disclose information for safety reasons, such as dangerous circumstances involving harm to self or others
  • When ordered or subpoenaed by the court
  • I must report abuse of children or mentally disabled/vulnerable adults to Child or Adult Protective Services


Your appointment time is reserved exclusively for you.  Another way of looking at it is that you are renting time with your physician.  Please give two business days cancellation notice for any appointment that you cannot keep.  Full fees are charged for missed appointments and cancellations with less than two business days notice.  Insurance does not reimburse any portion of these fees.  The no show fee for a 30 minute visit is $175.  the no show fee for a 60 minute appointment is $275.  Exceptions are made for serious medical illness.  If you miss an appointment, you will be informed of the event and your credit card or debit charge will be charged for the fee within 24 hours.


I write prescriptions for new medications or for refills during the appointment.  If a refill between visits is necessary, please ask your pharmacy to fax me directly to request refills.  The fax number is 206-728-5876.  Please allow 72 hours for refills.  They normally do not take this long, but faxed refill requests will not be reviewed until the next business day.


Letters for work or for school and any insurance or leave paperwork must be submitted to me during an appointment.  Please note that I may not be able to accommodate all requests.


The preferred method for non-urgent communication is via the patient portal.  I explain how this works at the time your first appointment is scheduled.  This allows for a secure electronic means of communication, and it requires that you have a personal email address.   The telephone works too and my number is 206-778-5584.  If you are in a crisis and require an immediate response, then I recommend calling either 911.