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For Patients

Patient Forms

Oregon Eye Specialists, PC is grateful for the opportunity to fulfill your eye care needs! We look forward to providing you with the personalized care you deserve. In order to make your next visit with us as efficient as possible, please take a moment before your scheduled appointment to print and complete the following patient forms:

 

  • Medical History – The information requested in this form better allows our physicians to care for you and must be updated annually. Please fill out before your next visit and also include with it a list of current medications.
  • Why Does OES Ask For My SSN and ID? – Every time you come in for an appointment our clinics will need to appropriately identify you, as will many insurance companies we may be billing on your behalf. Please read this form carefully for a detailed explanation on why we request specific identification.

If you prefer, we also welcome you to complete these forms in our office by arriving 10-15 minutes early to your next scheduled appointment.

In some cases, Oregon Eye Specialists may need your primary care physician to share pertinent medical information with us which requires your authorization. Please fill out a Medical Release Form and/or a Records Release Form, if applicable.

For your convenience this is our Privacy Practices Notice to read before your next visit. If you are unable to do so before arriving, hard copies are also available in our clinic.

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Contact Us

For general questions void of sensitive or confidential information please fill out the fields below. For Secure Messaging please create a My Patient Portal account and send your message via the portal.

*Sensitive or confidential information such as health information or billing information should not be sent using the Contact Us feature. Please allow 2 business days for a response. Do not use the Contact Us feature for urgent inquiries. If you are experiencing a medical emergency call 9-1-1.