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FORMS
This is an Adobe Acrobat PDF file Consent to Use and Disclose Protected Health Information (33kb)
This is an Adobe Acrobat PDF file Financial Responsibility and Assignment of Insurance Benefits (24kb)
This is an Adobe Acrobat PDF file Medical History (66kb)
This is an Adobe Acrobat PDF file Directions to our Clinic (20kb)

Open window to show Google map to itOne Lincoln Center, Suite 410
10300 SW Greenburg Road
Portland, OR, 97223-5417		 Telephone: (503) 517-8555
Fax: (503) 517-8556
Email: bob.buckendorf@gmail.com