Prospective patients

Thank you for your interest in becoming a patient.

Please review our FAQs for new patient questions and also for the most common questions regarding insurance, billing and charges.

Once you're ready to take the next step, click the Initial Inquiry link below. It brings you to a secure login for sharing basic information and asking additional questions.

Initial Inquiry

Next steps

Expect a response from your Initial Inquiry Form in approximately 4-10 days, (frequently sooner). We will contact you using the information you've provided. Once any Q&A's have been worked through, the next step will be Patient Forms. Links to those forms can be found below.

New patient forms

Health Questionnaire

(Coming Soon)

***Required***

Complete this form only after you've received a response to the Initial Inquiry form, and after any questions have been answered satisfactorily.

This form is comprehensive and may take time to complete. We will need this completed form in advance of scheduling.

Please note that the 3 day diet diary does not need to be consecutive days.

Records Release

***Required***

(optional if you have not had medical care in the last two years)

Use this template to request pertinent records from other providers.

Turn the completed form(s) in to your provider(s) or send to us and we will fax the requests for you.

Most providers are quick responders, but it can take up to 30 days for records. We require records in advance of your appointment in order to provide a comprehensive review

New Patient Intake

***Required***

Completion of this form allows for the creation of your chart. We collect complete demographics, updated insurance or payment information, and other information. In it we also provide HIPAA and financial policies, in addition to communication authorizations.

Authorization to Share Information

(Coming Soon)

***Optional***

This form allows you to authorize sharing of information with a spouse, relative or significant other in order to coordinate care.

It's used most often to delegate responsibilities, such as appointment scheduling or relaying of information to someone besides the patient.

Oregon Optimal Health

Living better longer

Prospective patients

Next steps

New patient forms

Health Questionnaire

Records Release

New Patient Intake

Authorization to Share Information