ATTENTION: If you think you are experiencing COVID-19 symptoms, call our COVID-19 triage line at 503-814-0099 before entering a Salem Health Hospitals and Clinics facility. This includes staff. Anyone at a Salem Health facility (inside or outside) must wear a facial mask at all times.
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Patient Forms

Lose a form from your last appointment? Need to make an update? Please print, fill out and bring the medical history and medication list forms to your next appointment.

Minors/pediatrics (0 to 17 years of age)

Adults (18 and older)