Helpful forms2019-02-05T10:40:33+00:00

Helpful forms

Please complete the appropriate forms below before your office visit. This will save you time in the waiting room. You can fax the forms in advance (Fax# 541-484-0155) or bring them with you to your visit. Eugene Pediatric Associates accepts all major health insurance plans. Please bring your insurance information at the time of your visit.

Additional Patients Minors Under 13 Years Old

Informed Consent

Minors Privacy Notice

Notice of Privacy Practices

Office and Financial Policy

Patient Centered Primany Care Home Program Consent

Patient Contacts

Patient Registration Age 13-17

Patient Registration Age 18 and Older

Patient Registration Minor Under Age 13

Release of Information Forms From EPA

Release of Information Forms To EPA

Sports Physical

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