Behavioral Health
7704.8 miles away
541-387-6138
Fax: 971-712-2139
Mon - Thur: 8:30 a.m. - 5:30 p.m. / Fri: 8:30 a.m. - 4 p.m.
Behavioral Health
Mon - Thur: 8:30 a.m. - 5:30 p.m. / Fri: 8:30 a.m. - 4 p.m.
Forms and Information
Registration forms
- Patient Information - English (Spanish)
- Authorization to Release Medical Information
- Patient Responsibility for Payment - English (Spanish)
- Patient's Right to Appeals and Grievances - English (Spanish)
- Notice of Privacy Practices
- Consent to Use Telehealth Services - English (Spanish)
Adult patient forms
- Health History - English (Spanish)
- New Patient Medication Management Form - English (Spanish)
- New Patient Therapist Form - English (Spanish)
Child and adolescent patient forms
Find a Doctor
At Providence, you'll have access to a vast network of dedicated and compassionate providers who offer personalized care by focusing on treatment, prevention and health education.
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