New Patient Paperwork & Forms

New patient paperwork is provided electronically through the Charm patient portal under "questionnaires". Please make sure the forms are completed and submitted prior to your visit. 

Here's a check list of what you will need to complete:

  • New Patient  Health Intake

  • Insurance-Financial-Office Policies & Consent to Treat

  • HIPAA Notice

* If you're scheduled for Acupuncture, you'll receive an additional acupuncture consent form. 

* If scheduled for a Telemedicine visit, you'll receive an additional telemedicine consent form. 

* For in-person visits, during the pandemic, you will also receive a COVID-19 questionnaire that should be completed within 24 hours of your visit but not sooner. 

If you have any issues with the electronic forms, pdf's are available below. Please print out and bring completed with you to your visit if in-person. If a telemedicine visit, please fax to 503-673-8051 or send paperwork via messaging in the patient portal.

New Patient Health Intake:                                HIPAA Policies:

 

Insurance-Financial-Office Policies & Consent to Treat:

Other Forms:

Acupuncture Consent to Treat:                                      Medical Release Form: