(541) 474-5533

Resources

Patient Forms

Absence Request (PDF)
Acknowledgment and Consent (PDF)
Appointment Confirmation (PDF)
Authorization to Disclose Information (PDF)
Disclosure of Medical Records (PDF)
Elective Self Pay (PDF)
General Surgery Assessment (PDF)
Patient Intake Form (PDF)
Patient Informed Consent (PDF)
Patient-Informed Consent - RFA (PDF)
Patient-Informed Consent - Foam Sclerotherapy PDF)
Work Release Form (PDF)

Patient Forms - En Español

Acknowledgment and Consent (PDF) - en Español
Appointment Confirmation (PDF) - en Español
General Surgery Assessment (PDF) - en Español
Patient Intake Form (PDF) - en Español

Pre-Op and Post-Op instructions

Bowel Prep Instructions (PDF)
Breast Health Assessment (PDF)
Post-Op Instructions - RFA (PDF)
Venaseal Aftercare Instructions (PDF)

Referring Offices

Information for Referring Office (PDF)
AllCare Independent Physician Association Logo

Trusted Physician Association Member

We are a proud member of the AllCare Independent Physician Association. Along with more than 70 independent physicians in Josephine and Jackson counties, we’re working together to provide quality, cost-effective healthcare for our communities.

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