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PATIENT FORMS · WEST LINN, OREGON

Forms & Paperwork

Most forms are completed online through the patient portal. If you need paper copies, you can download and print them below.

START HERE

Start with a short request. We’ll send you forms and call to schedule.

​New client?

Adults (19+)

PDF

Contact, insurance and emergency contact details.

Adult Registration Information

PDF

Background that helps your clinician get to know you.

Adult History Form

Children & teens

PDF

Completed by a parent or guardian.

Child & Adolescent Registration Information

PDF

Your child’s development, school and health background.

Child & Adolescent History Form

PDF

For separated or divorced parents: consent and custody paperwork.

Divorce Policy

Consents & policies

Fill them out online

The patient portal is the fastest way. Your forms go straight to our team, securely.

Returning paper forms

Bring them to your first appointment, or fax them to 503‑653‑1464.


Please don’t email completed forms. Email isn’t a secure way to send health information.

Questions about a form?

Our front desk is happy to help.

503-653-0631

PDF

What to expect from care with us. Every client signs this.

Informed Consent for Treatment

PDF

How we may contact you, plus recording and research choices.

Your Choices: Communication, Recording & Research

PDF

How we protect and use your health information.

Notice of Privacy Practices & Limitations

PDF

Lets us share information with a provider or school you choose.

Release of Information

Billing

PDF

Payments, insurance and cancellations.

Financial Policy Agreement

PDF

Your right to a good-faith estimate of costs.

No Surprises Act General Information

TMS

PDF

Only needed if you’re starting TMS treatment.

TMS Intake Forms

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