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Patient Forms

Please print the necessary forms, fill them out, and bring them into the office on your next visit. Click on the forms below to download and print.

Patient Registration (pdf)

Health Questionnaire (pdf)

HIPAA Form (pdf)

Exposure Questionnaire (pdf)   *patch test patients only

Patient Portal Consent (pdf)

Records Release Form (pdf)

Televisit Scheduling Instructions (pdf)

Insurance Information

We accept most major commercial insurances:

  • Aetna
  • Cigna
  • Health Net of Oregon
  • Regence BC/BS
  • Pacific Source
  • United Health Care

DISCLAIMER: Please contact your insurance plan directly prior to scheduling to verify your network plan benefits for our provider.

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