Please complete the follow application to have your child placed on our waiting list. Please Note: All questions must be answered. If it does not apply to you or your child, select or input 'N/A' - Applications with skipped answers will be discarded.
To be considered for a spot, the following must be turned after your submit your application:
*Recent Well Child Exam
*Recent Dental Exam (1 yr+)
*Immunization Report/or Exempt Letter
*Parent/Guardian ID
*Child Insurance Information
*Medical Documentation if Necessary
*Student Schedule or ID Number
If you have any questions, please call our office at 253.589.5531
***If you have multiple children you would like to place on the wait-list, please fill out an additional application and submit it***