In order to expedite your first visit to our office, simply download, print, and fill out the following forms and fax them to our office (541) 935-6608, or bring them with you to your visit. If you would like further information regarding our physicians, or services we have to offer please contact our office directly at 541-935-2035.If you do not have Adobe Acrobat Reader, click on the following link to download the program to be able to view Adobe PDF forms.

We are proud to be members of LIPP, Lane Independent Primary Physicians

Patient Forms

Authorization to Use Medical Information
Medical History Form
Privacy Policy
Patient Registration
Payment Policy

— Registration —

Patient Forms