Forms

These forms are in Adobe PDF format. Please complete the forms online.

On most newer computers (with version 8 or newer Adobe Reader) you can also send the completed forms directly from your computer (see EMAIL button in bottom right corner of each form). You may also print the forms for your records.

Authorization & Registration Forms, Policies, & Notices

Authorization to treat in the absence of parent or guardian

Authorization to Release Medical Records

Financial Policy (for minors)

Financial Policy (18 yrs and over)

Patient Registration Form (for minors)

Patient Registration Form (18 yrs and over)

Privacy Notice

 

 

 

The above forms are PDF files. They can be viewed with Adobe Reader. If your computer does not have Adobe Reader installed you can get the free software here.

 

 

 

Olson Pediatric Clinic
16463 Boones Ferry Road, Ste 400
Lake Oswego, OR 97035

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