New Patient Instructions

On this page you will find forms to help us establish your care at our office.  Choose the appropriate documents for yourself and/or your child – then it’s as easy as 1-2-3-4.

 

  1. Complete the on-line Health History form (this can be done in the office if you don't have a computer) 
  2. Print items 2-5.  Add 6 or 7 if applicable
  3. Complete/Sign those documents you printed
  4. Bring to the office

We know it’s a lot of reading and writing, so we promise to take good care of the information (and you) once received.

For ADULTS:

  1.  Personal Health History
  2. Privacy Practices Notice  
  3. Privacy Practices Acknowledgment
  4. Consent to Treat
  5. Financial Policy
  6. Motor Vehicle Accident lien (when applicable)
  7. Worker’s Compensation Injury lien (when applicable)

For CHILDREN: Complete item 1, then download, print and complete documents 2-5 and add 6 if necessary. 

  1. Personal/Family Health History 
  2. Privacy Practices Notice
  3. Privacy Practices Acknowledgment
  4. Consent to treat a minor
  5. Financial Policy
  6. Motor Vehicle Accident lien (when applicable)

Any questions, simply call our receptionist at 503-224-2100 [ext. 0]