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
Patient Centered Primany Care Home Program Consent
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