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End of Life Washington
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Request Information

If you are a resident of the state of Washington and would like information about End of Life Washington’s free client support services, please complete and submit this form, OR contact us at 206.256.1636 during our regular business hours (Monday-Thursday, 8 a.m.-6 p.m.). Please note that messages left outside of regular business hours will be returned at the beginning of our next business day.

Information Request Form

  • Name * Required
  • Address
  • Please note: if you are terminally ill and seeking a peaceful death, please complete the Death with Dignity Support Request Form found under CONTACT in our main menu.

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