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New Patient Information

Required Forms

Primary Care

Mental Health

Substance Use Treatment

Other Forms

Thank you for choosing Adapt Integrated Health Care as your health care home. Whether you’re seeking primary care, mental health care or substance use treatment, this page contains information to help you establish your care.

To help you prepare for your first visit, and save you time once you arrive, we encourage you to download and complete the forms for the health care services you are seeking. Please bring the completed forms with you to your first appointment.

If you need assistance or would like us to mail you the forms, please call us at the numbers provided below.

Required Forms for All New Clients & Patients

All new patients must complete these forms.

Primary Care Forms

If you need assistance or would like us to mail you the forms, please call our office at (541) 492-4550.

Adult Forms

Download All Required & Adult Primary Care Forms (English | Español)

Child-Adolescent Forms

Download All Required & Child-Adolescent Primary Care Forms (English | Español)

Psychiatric Medical Forms

Download All Required & Psychiatric Medical Forms (English | Español)

Mental Health Forms

If you need assistance or would like us to mail you the forms, please call the office nearest you: Douglas County (541) 440-3532, Curry County  (877) 408-8941

Douglas County

Download All Required & Mental Health Forms – Douglas County

Coos County

Download All Required & Mental Health Forms – Coos County

Substance Use Treatment Forms

If you need assistance or would like us to mail you the forms, please call the office nearest you: Douglas County (541) 492-0152, Coos County (541) 751-0357, Josephine County (541) 474-1033

Douglas County

Download All Required & Substance Use Treatment Forms – Douglas County

Coos County

Download All Required & Substance Use Treatment Forms – Coos County

Josephine County

Download All Required & Substance Use Treatment Forms – Josephine County

Other Patient Forms & Information

Financial Forms

Other Patient Forms & Information

This health center receives U.S. Department of Health and Human Services (HSS) funding and has U.S. Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.