PATIENT FORMS

Please download, print, and complete the following Adobe Acrobat PDF forms:

New Patient Registration & Financial Policy form

All new patients must complete this form to set up an individual account with Family Wellness Center. Bring completed form along with your insurance card with you to your first appointment.



Adult New Patient form

All NEW adult patients must complete this form and bring it to their first office visit appointment.


Children & Teens Under Age 18 form

A parent of a NEW pediatric patient should complete this form and bring it to their child’s first appointment at Family Wellness Center.



Annual Physical form

Adult patients scheduled for a complete physical or well woman exam should complete this form and bring it to their appointment.

Appointments
503-847-BACK
Call to Schedule an Appointment Today.
Office Hours:
Monday » 9am - 5pm
Tuesday » 9am - 1pm
Wednesday » 9am - 5pm
Thursday » 9am - 5pm
Friday » 9am - 1pm
Saturday » Call
Sunday » Call