Patient Forms

Medical History Form

All new patients and patients we haven’t seen within two years must fill out a medical history form. You can now fill out your medical history form at home and have the information in our electronic health record when you arrive. This will save you time and make the check-in process easier for you.

You can also print a pdf of the form to fill out if you prefer, or call 541-322-2353 to give your medical history by phone.

Notice of Privacy Practices

This policy describes how medical information about you may be used and disclosed and how you can get access to this information.

Medical Records

Release of Information

For more information on obtaining your medical records, please click here or call 541-322-2350.

Communication Form

HIPAA Communication Form

The Center may need to communicate with your family or caregivers. By law, your authorization is required for us to do so.

Patient Portal Proxy Form

Proxy Form

To enroll a child or an adult you make health decisions for, please fill out this form and bring it to your next appointment. Click here to request a connection for yourself.