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 2018

Additional Forms

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

  • Health History – Medical Health history form
  • HIPAA – Privacy Practices Document
  • ROI – Medical Records Release of Information
  • Shared Info – Family/Friend Shared Information Release
  • Intake Form – For New Patients of Ashley Love