Patient Forms

Whether you are a new patient to Colorectal Health NW or it has been more than 1 year since you were last seen, you will need to update your paperwork. Alternatively, you can print each form below and bring the completed forms with you to your appointment.

  • Office Visit or Colonoscopy - please complete these forms if you are a new patient or it's been more than 1 year since your last visit:
  • Release of Information
    • Medical Records Request [PDF] [Online]
    • Patient Confidential Communication Consent [PDF] [Online] (This form allows us to speak to family or caregivers regarding your personal medical information)
  • Clinic Policies
    • HIPAA Acknowledgement and Consent [PDF]
    • Consent for Treatment [PDF]
    • Financial Agreement [PDF]
    • HIPAA Notice of Privacy Practices [PDF]

Colorectal Health NW

Address

9155 SW Barnes Rd. Suite 231,
Portland, OR 97225

Hours of Operation

Monday  

8:30 am - 5:00 pm

Tuesday  

8:30 am - 5:00 pm

Wednesday  

8:30 am - 5:00 pm

Thursday  

8:30 am - 5:00 pm

Friday  

8:30 am - 5:00 pm

Saturday  

Closed

Sunday  

Closed