Forms

Find What You Need. Feel Prepared.

  • Man holding a sleeping baby and looking at a smartphone with a laptop open on the table in front of him in a cozy kitchen.

    For Your Review

    Welcome to our information center. Here, you will find important documents to help parents and providers give great care. Understanding these resources ensures compliance and strengthens our partnership in caring for your child.

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  • A woman and a young boy sitting on a beige sofa, looking at a tablet and smiling, with cushions and a potted plant in the background.

    New Patient Forms

    Our New Patient Forms are important for starting your child's healthcare at Oregon Pediatrics. They help us learn about your child's medical history and your preferences, allowing us to work together on your child's health. Filling out these forms enables us to offer tailored and effective care, supporting your child's well-being.

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  • A young baseball player in a blue jersey and white pants hitting a ball with a bat at a baseball game, with a baseball catcher in gear kneeling behind him and spectators watching from the bleachers behind a chain-link fence.

    Wellness Visit

    Explore our well child care visit forms, thoughtfully designed to enhance your child's health and development. These forms are instrumental in providing tailored care and safeguarding your child's well-being

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  • A woman and a girl sitting on a beige carpet playing with colorful wooden blocks. The woman is holding a clipboard and smiling as she interacts with the girl, who is also smiling and looking at the blocks.

    Behavioral Health

    In our commitment to providing holistic care, we offer a range of behavioral health forms that facilitate a deeper understanding of your child's emotional and mental well-being.

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  • A woman sitting at a desk, reviewing papers with a tablet nearby, in a bright living room with a child playing in the background.

    Billing & Financial

    Our billing and financial forms are designed to keep you informed. By reviewing these forms, you're taking an essential step towards ensuring a smooth and stress-free financial experience with us.

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  • A young girl in a light blue shirt shows a thumbs-up while receiving a vaccine from a nurse, with other children in the background also getting vaccinated.

    Vaccination Forms

    Our Vaccination Forms are designed to ensure your child receives essential vaccines, protecting them from preventable diseases. These forms help us keep accurate records of your child's immunization history, enabling us to provide the best care possible.

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For Your Review

  • We are committed to providing quality healthcare and respecting your patient rights. We take all feedback, comments, and/or concerns very seriously and will not retaliate for filing a complaint.

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  • The HIPAA Notice of Privacy Practices outlines the protection of your child's health information, ensuring confidentiality and compliance with privacy regulations.

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  • As a patient, you have a right to receive quality care. This form shares more education on your rights and responsibilities.

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Patient Forms

  • Our patient registration forms streamline the onboarding process, enabling us to gather essential information about your child.

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    General Registration Form

    Lactation Registration Form

  • This form gives us permission to securely obtain and share your child's health information as needed

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  • The Authorization of Delegate form allows you to designate a trusted individual who can act on your behalf when it comes to your child's healthcare, ensuring seamless communication and support.

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  • Proxy access allows access to MyHealth accounts for patients 14 years and older. Proxy can be revoked at any time.

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Wellness Care

  • The Sports Physical forms are essential for ensuring your child's readiness and safety in sports activities, helping our team assess their physical health and fitness for participation.

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  • The Wellness Schedule form helps you stay on top of your child's health by providing a structured plan for their wellness visits and immunizations, ensuring they receive the necessary care at the right time.

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Behavioral Health Forms

  • The ADD-ADHD Vanderbilt Form is a valuable tool that assists us in understanding your child's behaviors, ultimately helping us provide the most appropriate care and support.

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    For Parents

    For Teachers

  • This form grants Oregon Pediatrics permission to securely obtain and share your child's health information .

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Billing & Financial

  • Our financial policy outlines the responsibilities of patients for payment at the time of service, including insurance verification, co-pays, and any additional charges not covered by insurance.

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  • Our "no-show" policy provides information if an appointment is missed without prior notice.

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Have Questions?

If you have questions or need help with our forms or care, please contact us. Our team is here to support you and your family.

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