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Patient Forms

We know the day of your surgery can be stressful, and being asked to complete medical forms when you arrive, can add to the stress. That's why we've taken extra measures to streamline the process. Now, for added convenience and better organization, you can fill out each of your forms online (or in a fillable pdf) prior to your appointment. See details below for each document.

Hero patient forms
Hero patient forms mobile

Online Medical History Form

In order to provide excellent care and minimize long phone interviews and paperwork, Bend Surgery Center asks that patients complete online registration with One Medical Passport®. This website can be accessed via the link below and will guide you through a series of questions about your medical history.

Oregon Advanced Directive

Bend Surgery Center asks that patients complete the Oregon Advanced Directive form. This document informs our staff of the health care representative you'd like to act on your behalf, in certain medical matters. Specifically, the form outlines medical treatment options you would choose, should you not be able to speak for yourself.

Medical Records Release Form

The Medical Records Release Form is used to authorize a health care provider (physician, dentist, hospital, chiropractor, psychiatrist, etc.) to release a patient's medical records to the patient, a third party (such as an employer or insurance company), or both.