New Patient Forms

New Patient Forms at Benson Health Clinic in Eugene Oregon

Please find the necessary forms below for your first appointment or for your own reference. Contact us if you have any questions.

General New Patient Forms

New Patient Packet

Additional Forms

Below are additional forms that may be of benefit to you during your visit.

  • Health History – For New Patients of Chris Tower PMHNP, William Morris DNP, PMHNP, and Cory Hoover PMHNP
  • Health History – For New Patients of Alyson Lumos, DNP, PMHNP
  • Health History – For New Patients of Jill Loy, PMHNP
  • Health History – For New Patients of Miriam Thornton, PMHNP
  • Health History – For New Patients of Ayisha Sanda, PMHNP
  • HIPAA – Privacy Practices Document
  • ROI – Medical Records Release of Information
  • Shared Info – Family/Friend Shared Information Release