Forms

Find What You Need. Feel Prepared.

For Your Review

  • We are committed to providing quality healthcare and respecting your patient rights. We take all feedback, comments, and/or concerns very seriously and will not retaliate for filing a complaint.

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  • The HIPAA Notice of Privacy Practices outlines the protection of your child's health information, ensuring confidentiality and compliance with privacy regulations.

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  • As a patient, you have a right to receive quality care. This form shares more education on your rights and responsibilities.

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Patient Forms

  • Our patient registration forms streamline the onboarding process, enabling us to gather essential information about your child.

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    General Registration Form

    Lactation Registration Form

  • This form gives us permission to securely obtain and share your child's health information as needed

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  • The Authorization of Delegate form allows you to designate a trusted individual who can act on your behalf when it comes to your child's healthcare, ensuring seamless communication and support.

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  • Proxy access allows access to MyHealth accounts for patients 14 years and older. Proxy can be revoked at any time.

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Wellness Care

  • The Sports Physical forms are essential for ensuring your child's readiness and safety in sports activities, helping our team assess their physical health and fitness for participation.

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  • The Wellness Schedule form helps you stay on top of your child's health by providing a structured plan for their wellness visits and immunizations, ensuring they receive the necessary care at the right time.

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Behavioral Health Forms

  • The ADD-ADHD Vanderbilt Form is a valuable tool that assists us in understanding your child's behaviors, ultimately helping us provide the most appropriate care and support.

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    For Parents

    For Teachers

  • This form grants Oregon Pediatrics permission to securely obtain and share your child's health information .

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Billing & Financial

  • Our financial policy outlines the responsibilities of patients for payment at the time of service, including insurance verification, co-pays, and any additional charges not covered by insurance.

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  • Our "no-show" policy provides information if an appointment is missed without prior notice.

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Have Questions?

If you have questions or need help with our forms or care, please contact us. Our team is here to support you and your family.