PATIENT REGISTRATION FORMS

We ask that all new patients download, print and complete a patient registration packet.

Should you have any questions, our staff will be happy to assist while completing your registration.

PDFs: You will need Adobe Acrobat Reader to view and print PDF forms. If you do not have this program, you may download it for free here.

Download a Patient Registration packet per provider:

Telephone Disclosure Form

NOTE: Dr. Newton is by referral only. His patient registration packet is distributed by his care team. Please call our office for details at (541) 282-2200.

Please read our HIPAA Privacy Policy (PDF) before coming for your appointment.

On appointment day:

  • With thousands of insurance and pharmacy plans available, and identity theft a potential risk, we need to confirm your identity and insurance coverage every time we see you.
  • Please bring a photo ID, and your insurance card with you to your appointments at SOIM. If you have a prescription card, please bring this to your appointment as well.
  • Please plan to pay your copay or your portion of the cost for your visit when you arrive for your appointment..

Copies of Medical records:

  • If you would like a copy of your complete medical record, we will need a formal request from you, which must be completed in writing and signed by you or your authorized representative. For your convenience a Medical Release form PDF* can be downloaded and submitted via fax or to the address included on the form.
  • Please allow 30 days for medical record requests. There is a small copying charge.

Download a Medical Release form here: