Paperwork to Download

New Patient Paperwork For Patients OVER 18 years of Age:

New Patient Paperwork for Patients UNDER 18 years of Age:

Transferring Medical Records:

The following form must be filled out and signed and presented in person to the clinic. It is especially important that Dr. Fixott receive your previous medical records if you are on chronic pain medications. Please note that she may refer you to a chronic pain specialist. She will not prescribe pain medications unless we receive records directly from your previous provider.  Call us to clarify if you have any questions or need help filling out the form: 541-316-2277

Notification of Privacy Practices

The following form DOES NOT have to be printed off. It is purely for notification purposes. A laminated copy will be presented to you at the time of your appointment, along with a form to sign acknowledging that you understand and accept our practices. Paper copies are available upon request.