You will be given a unique pass code at the time of scheduling to use on our secure server. Click the link below ONLY when you have your pass code ready. Please complete all 5 tabs thoroughly.
When you reach the final tab (SUBMIT DATA) and scroll to the bottom on the page. First, click the box to agree to the above disclosures and then click the button "SUBMIT DATA." If you fail to click the box and the button, we will not obtain your information.
If you prefer forms on paper instead of electronically, this can be printed at home. We ask you to please bring it in completed at least 24 hours before your appointment.
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Call: 541-378-0033 Text only: 541-275-1843