New Patient Inquiry

If you would like to set up an initial appointment with one of our providers, please complete this form. Dr. Cooper and Kristen Rheinlander, PA-C work as a collaborative team.

If you have read about our services and feel you are a good fit, please contact the front desk directly and complete this form. Our front desk can help answer any questions and schedule your appointment. Please call us at 206-632-4575 or email us at info@coopermetabolic.com. This is a HIPAA secure form.

First Name *

Last Name *

Phone with area code *

E-mail *

Do you reside in Washington State? *

Yes

No (please list the state where you reside) No (please list the state where you reside)

Please tell our providers a little bit about your reason for seeking care and your health goals. *

How did you hear about our clinic? *

Primary Care Provider

Pediatrician

Other Other

Would you like to receive updates from Dr. Cooper's nonprofit, the Diabesity Institute? *

Yes