Below are several documents that may assist us in providing you with our best medical care. Please review and complete the appropriate forms prior to your visit. If you have any questions about any of the information below, please feel free to call our office at (503) 325-5300.

Document Packets Required at Initial Visit:

Documents must be completed at the time of your initial visit with your healthcare provider. If you are unable to download and complete these forms at home, we will mail them to you upon request, or have them available for you at the clinic to pick up.

  • Please plan to arrive 15 minutes early for your appointment with documents completed, and bring your insurance card/s with you.
Adult Packet (ages 18+)
Adolescent Packet (ages 12-17)
Pediatric Packet (ages 0-11)

Ages and Stage Questionnaires

We wish to thank you, as your doctors, for allowing us to be an important partner in your child’s future. As your child’s medical professionals, we regularly use Ages and Stages questionnaires (ASQ) to verify development and social-emotional screening for children from two months to 4 years of age. We systematically screen infants and young children for developmental and social-emotional delays in the crucial early years of life.

Because of the rapid changes in the early years, the American Academy of Pediatrics and others recommend that infants and young children be screened on a regular basis. We can use each age-specific ASQ at intervals to watch for and catch developmental and social-emotional delays that may not be detected in a single screening. We request that you take the time to complete the age specific questionnaire and bring it with you so that your physician can review it during your child’s office visit.

Documents must be completed at the time of your child’s visit with their healthcare provider. If you are unable to download and complete these forms at home, we will mail them to you upon request, or have them available for you at the clinic for pick up.

Medical Record Forms

Records Release to PFM
Medical Release from PFM
Patient Portal