Request Information About Concierge Medicine

The Concierge Medicine program currently has a waitlist to accept new members. Please submit an inquiry form indicating which location and/or physician you are interested in, and we will contact you when an opening becomes available for your requested location and/or your preferred provider.

First Name *

Last Name *

Email Address *

Phone Number *

Are you a Virginia Mason Franciscan Health Patient? *

Yes No

Please choose the Concierge Medicine Location(s) that you are you interested in *

Bainbridge Island Bellevue Seattle

Please provide specific details as to how you heard about us *

For example: please list the name of the Concierge Medicine member, Doctor, employer, friend, or other source who referred you.

Please tell us why you are interested in our Concierge Medicine program *

Do you have specific questions regarding Concierge Medicine that we may help with?

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