Schedule a call with a patient care coordinator

Thank you for your interest in proton therapy. Please take a moment to fill out the form to have a patient care coordinator call you.

Once the form is completed, you will receive a confirmation email. Our team generally returns calls within 48 hours Monday through Friday between 8:00am and 4:00pm. If you would like to speak with a patient care coordinator quickly, please call us at 1-855-528-7248.

Name
The following applies to my diagnosis: *
How did you hear about us?

Checklist of items you will need for your initial call with us

You provide:

  • Demographic information (legal name, etc.)
  • Insurance information
  • Related doctor and facility information
Ask your specialist(s) to provide:
  • Pathology report - positive lymph node involvement?
  • Clinical notes
  • Imaging
  • Records regarding significant past medical history or surgeries: lumpectomy or mastectomy

This form is unsecured and is for general information requests only. Please do not use this form for questions or comments regarding personal health information or for time-sensitive matters.

Electronic communication with Fred Hutchinson Cancer Center – Proton Therapy, whether by email or through this website, is an unsecured means of communication. Fred Hutchinson Cancer Center – Proton Therapy cannot guarantee the confidentiality or privacy of information communicated electronically. Such information may be read by people other than yourself or your healthcare provider (such as your employer if you use your work email or computer, your internet service provider, or an administrative employee). In addition, electronic communication is not a reliable means of communication regarding time-sensitive matters.

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