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541-349-9333

Patient Registration Forms

 

Please print and fill out this paperwork packet and bring it to your appointment. 

Bring a list of any medications you are on along with the dosages.

Check in 15 minutes prior to your scheduled appointment time.

Bring your insurance cards and a patient photo ID if you are 18 years or older.

If you have a copay we do accept checks or cash but no card payments. 

 

Patient Registration Forms (3 signatures required throughout the packet)
 

Medical Record Release Form (Not required)