Forms & Information

Providence Medical Group wants to help ease the way of our patients by providing new patient medical forms and privacy notice information in advance of their first visit.

Please review all of the information below and complete the necessary forms prior to any patient’s first appointment to allow for quick and easy processing.

Complete these forms

  • Providence Medical Group Health History Form
  • Medical Records Transfer Form

Review this information

  • Notice of Privacy Practice

Forms Instructions

Health History Form - Primary Care Southern Oregon

As part of our new patient paperwork, please complete this medical history form prior to the patient's first appointment.

Medical Records Authorizations

Providence Health & Services provides access to medical records from our hospitals and other medical facilities in Oregon to patients and their authorized representatives.

Notice of Privacy Practices

Please review prior to the patient's first appointment.

Well child checklist

A list of developmental questionnaires from birth to age 21. 

Well child checklist-Spanish

Una lista de los cuestionarios de desarrollo desde el nacimiento hasta los 21 años.