Patient Forms

Here you will find the important forms and instructions for our women’s health care clinic in Eugene and Springfield Oregon.

 The Fertility Center of Oregon

• New Patient Forms

Women’s Care

New Patient Forms

• Medical Records Authorization To Release Records Form

Preop

• General Pre-Operative Checklist
  

Postop

• Discharge Instructions after Hysterectomy and Vaginal Hysterectomy

Notice of Privacy Practices

• Notice of Privacy Practices (NPP)

Request for Medical Record Amendment/Correction

• Request for Medical Records Amendment

Reproductive Endocrinology

• New Patient Forms

The Continence and Support Center

New Patient Forms

• Patient Information Form

Preop

• What to Expect Before Urodynamics
  

Postop

• What to Expect After Urodynamics
  

Worksheets

• Bladder Diary

Center for Genetics & Maternal-Fetal Medicine

New Patient Forms

• Medical and Family History
• Records Release – TO MFM
• Records Release – FROM MFM