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New Patient Forms

Primary Care

Mental Health

Substance Use Treatment

Other 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, Coos County (541) 751-0357, Curry County (877) 408-8941

Douglas County

Download All Required & Mental Health Forms (English | Español)

Coos County

Download All Required & Mental Health Forms (English | Español)

Curry County

Download All Required & Mental Health Forms (English | Español)

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, Curry County (877) 408-8941

Douglas County

Download All Required & Mental Health Forms (English | Español)

Coos County

Download All Required & Mental Health Forms (English | Español)

Josephine County

Download All Required & Mental Health Forms (English | Español)

Curry County

Download All Required & Mental Health Forms (English | Español)

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.