Care that already knows the protocol.

TULQ is an anglicized form of tultxʷ, the Lushootseed word the Snoqualmie people have long used for the place at the confluence of the Tolt and Snoqualmie rivers, in what is today the town of Carnation, Washington. The village name túlq is the root from which the English place-name "Tolt" was derived. It is the heritage of our founder, and it is where the name comes from.

It is a word about meeting. Two currents, joining. One water. We kept it deliberately, because the work we are building is itself a confluence: clinical rigor and the protocols, the nurse and the patient, the regulation and the organization responsible for satisfying it.

TULQ's founder, Michael Chavez Ross, is an enrolled citizen of the Snoqualmie Indian Tribe and a former Vice Chairman of the Snoqualmie Tribal Council. He worked on Capitol Hill in Washington, D.C., on healthcare and public-interest legislation, and spent three years helping run a community health and wellness clinic. The name TULQ honors that heritage, and the operational grounding it gave him is part of how the line runs today.

The clinical backbone is Jayson Forrest Minagawa, RN, BSN — eleven years and a dozen ICUs deep, from a Level 1 Trauma Center to cardiovascular intensive care, telehealth-into-the-home, corrections triage, and skilled-nursing leadership. He has actually carried the pager.

For a hospice, a health center, a rural hospital, or a busy practice, the after-hours call is the moment everything else depends on. Too often the patient reaches a recording, a hold queue, or an answering service that takes a message and wakes up an exhausted on-call clinician for something a nurse could have resolved on the phone. Triage that does not follow validated protocols misreads the call. A line that does not document the encounter leaves the organization unable to show it was covered.

TULQ is what it looks like when a nurse-led company builds the line from the inside out: licensed RNs working Schmitt-Thompson Clinical Content, the framework 95% of U.S. medical call centers use, paired with seasoned clinical judgment and AI-assisted intake. Not a hotline retrofitted to look the part. A line built for the organizations that are required to have one, and for the patients who pick up the phone hoping someone competent will answer.

The promise is small, and it is not small: when a patient calls at 3 a.m. with a child running a fever or a parent whose pain is changing, a U.S. state-licensed registered nurse answers, follows the protocol, and ends the call with a plan.

TULQ's focus is the organizations that, by regulation or accreditation, must have a licensed nurse reachable around the clock: federally qualified health centers, Look-Alikes, and Rural Health Clinics under HRSA after-hours coverage requirements; hospice and home health agencies under the 24-hour nursing Condition of Participation; Critical Access Hospitals under 24/7 emergency-coverage rules; and the direct primary care, pediatric, and OB practices that carry after-hours risk on a physician's cell phone. The same line, the same nurses, the same protocols.

We move carefully because it matters. We move quickly because the call has waited long enough.