Patient Forms

Download, print, and fill out forms to save time when you visit Cascade Internal Medicine Specialists. If you are unsure which forms you need for your visit, please call us at 541.318.0124.

New Patient Information & Medical History

• Patient Registration Form (PDF)
• Health History Intake Form (PDF)

Disclosure of Information

• Medical Records Request (PDF): Authorize us to receive medical information from a previous provider.
• Medical Records Release (PDF): Use this form to request a copy of your medical records.

Privacy Policy

We respect and appreciate your privacy. We follow general HIPAA (Health Insurance Portability and Accountability) guidelines. Please review this before your first visit. We ask that you complete, sign and turn in our "Acknowledgment and Consent" form to indicate you have received this information.

• HIPAA Privacy Policy (PDF)
• Acknowledgment and Consent to HIPAA Privacy Policy (PDF)
• Personal Health Information Release (PDF): Use this form to notify us of all individuals that you would like for us to be able to discuss your private health information should they call into our office on your behalf. We cannot discuss any of your private health information without this information.