New Patient Intake Forms & Resource

Please download and complete ONE of the following for your first appointment:

• New Patient – Insurence Patient Intake Form
• New Patient – Self Pay Patient Intake Form
• New Patient –(United Healthcare) Intake Form 
• Auto Accident Injuries Patient Intake Form
• Workers’ Comp Intake Form

• Aetna
• Cigna
• Pacific Source
• Providence
• Regence/Blue Cross Blue Shield
• United Healthcare 
• Oregon Moda (Comming soon)
• Kaiser CHP (Comming soon)
• All Auto Insurance

(We do not accept any government insurance)

• Allstate: File a Claim
• American Family: File a Claim
• Farmers: File a Claim
• Geico: File a Claim
• Liberty Mutual: File a Claim
• Metlife: File a Claim
• Nationwide: File a Claim
• Progressive: File a Claim
• State Farm: File a Claim
• Travelers: File a Claim
• USAA: File a Claim