Terms of Use

By agreeing to the terms of our secure forms, you will enter a secure area of our site. Northwest Clinic for Children will not be held responsible in the event your electronic message is not transmitted due to technical problems related to this site or to the hosting server. All personal identifying information is encrypted and your message will not be internally or externally forwarded to other third parties. The information will solely be used by Northwest Clinic for Children.

Your request will be processed within 48 hours, during normal business hours, Monday - Friday, 8:00 am -5:00 pm, excluding holidays.

If you do not accept the terms of this disclaimer, you will not be able to process your request and or form on-line. 

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Referral Request	AGREE
Prescription Renewal	AGREE
Online Bill Pay	AGREE