PATIENT RESOURCES

INSURANCE NOTICE OF PRIVACY PRACTICES PRIVACY POLICY GOOD FAITH ESTIMATE FINANCIAL ASSISTANCE LABORATORY PATIENT FORMS

Patient Forms

Please find our required patient paperwork below. For any questions, please call 503-445-7699 to speak with our front desk staff.

Primary Care Visits

Primary Care New Patient Paperwork – Health History

Primary Care New Patient Paperwork – Demographics

Collaborative Care Agreement

Patient Rights, Consents, Financial Policy

Release of Information

Time of Service Discount

Behavioral Health Visits

Behavioral Health New Patient Paperwork

Behavioral Health Informed Consent

Patient Rights, Consents, Financial Policy

Release of Information

Time of Service Discount

Optional Forms

Patient Grievance Form

Sliding Fee Scale Application

Fee Waiver Request Form

Zero Income Statement