Downloads

This page contains downloadable versions of the forms and documents used at our clinics. You can use these forms to fill out paperwork at home (or assist others), reducing any wait times during your office visit.

These files are presented in Adobe Acrobat (PDF) format, displayable on most computers. If you cannot open the files, try downloading the free Adobe Reader software.

Patient Information Sheet and Health Insurance Form

The following two forms are required of all patients. The first provides basic information about you, and the second provides more details about medical history, current symptoms, and insurance billing information:

• Patient Information Sheet
• Health Insurance Paperwork
• Privacy Policy

Motor Vehicle Accidents

If you have been involved in a motor vehicle accident, please provide the additional information required on this form:

• Motor Vehicle Accident Paperwork
• Right to Recovery

Workers Compensation Injuries

If you have been injured on the job or may need to file a workers compensation claim, please complete the following form:

• Workers Compensation Injury Paperwork

Patient Referral Form

For use by other medical services providers to refer a patient to one of our clinics:

• Patient Referral Form - Gateway Clinic
• Patient Referral Form - Clackamas-Milwaukie Clinic
• Online Referral Form - Fill out and submit a referral form via the web.

Questions?

If you have any questions about any of these forms, please Contact Us and we'll be happy to answer them.