Medical Forms
To better serve you, minimize waiting time at check-in, and provide accurate information, below are links to several valuable forms and questionnaires. Please note that these forms are general. You can visit the department page if you’re looking for a specific form.- Health Questionnaire
- Medical Record Release
- Medical Chaperone Form (Adult)
- Medical Chaperone Form (Pediatrics)
- Medicare Resources
- Oregon Advance Directive Form
- Race, Ethnicity, Language, and Disability Form (REALD)
Procedure Instructions
Before and after your scheduled procedure, these instructions provide vital information on preparing for your appointment and care afterward, including any necessary dietary restrictions, medication adjustments, and additional steps.- Anal Surgery Post-Op
- Breast Surgery Post-Op
- Colonoscopy Screening/Diagnostic
- Colonoscopy (NuLYTELY)
- Colonoscopy (SUPREP)
- Colonoscopy (SUTAB)
- Hernia Repair Post-Op
- Inpatient Surgery (Good Samaritan Regional Medical Center)
- Laparoscopic Surgery Post-Op
- Outpatient Surgery (Corvallis Clinic Surgery Center)
- Outpatient Surgery (Good Samaritan Regional Medical Center)
- Pain Treatment
- Pilonidal Surgery Post-Op
- Port-a-Cath Insertion Post-Op
- Procedural/Pre-Operative Showering Instructions
- Varicose Vein Ligation And Stab Phlebectomy Instructions
Medical Forms
To better serve you, minimize waiting time at check-in, and provide accurate information, below are links to a number of useful forms and questionnaires. Please note that these forms are general. You can visit the department page if you’re looking for a specific form.
- Health Questionnaire
- Medical Record Release
- Medical Chaperone Form (Adult)
- Medical Chaperone Form (Pediatrics)
- Medicare Resources
- Oregon Advance Directive Form
- Race, Ethnicity, Language, and Disability Form (REALD)
If you have any questions about a particular form or questionnaire or something not covered here, call us at (541) 754-1150.