Contact local office for appointments or call 1-866-599-3376

Patient Information

Welcome to Silver Falls Dermatology & Allergy. We’re pleased that you have chosen us to care for you and your family, and we’d like to make your patient experience as smooth and professional as possible.


New Patient Paperwork

If you are instructed to fill out new patient paperwork, please download and print these forms, and bring the completed packet to your first appointment.

Minor Patients

All patients under the age of 18 years of age must be accompanied by a parent or guardian at first visit.

All Patients

Please bring the following information to each appointment:

  • Driver’s license or photo ID
  • Current medical insurance card
  • Insurance co-pay, or Self-Pay co-pay (due at time of service)
  • A list of medications you are currently taking

Missed Appointments and Rescheduling

We understand that circumstances often arise that prevent patients from keeping their appointments. If you are unable to keep an appointment, please call our scheduling department as soon as possible so that we can inform your provider and stay on schedule with other patients.

Notice to Patients

Silver Falls Dermatology & Allergy complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Silver Falls Dermatology & Allergy does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Silver Falls Dermatology complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.


ATENCIÓN:  si habla español, tiene a su dispo     sición servicios gratuitos de asistencia lingüística.  Llame al 1-503-362-8385 (TTY: 1-866-599-3376).


CHÚ Ý:  Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.  Gọi số 1-503-362-8385 (TTY: 1-866-599-3376).


注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電1-503-362-8385 (TTY: 1-866-599-3376)。


ВНИМАНИЕ:  Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.  Звоните 1-503-362-8385  (телетайп: 1-866-599-3376).


주의:  한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.  1-503-362-8385 (TTY: 1-866-599-3376) 번으로 전화해 주십시오.


УВАГА!  Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки.  Телефонуйте за номером  1-503-362-8385 (TTY: 1-866-599-3376).


注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。1-503-362-8385 (TTY: 1-866-599-3376). まで、お電話にてご連絡ください。



ملحوظة:  إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان.  اتصل برقم (رقم هاتف الصم والبكم: 866-599-3376, 503-362-8385


ATENȚIE:  Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit.  Sunați la 1-503-362-8385 (TTY: 866-599-3376).


ប្រយ័ត្ន៖  បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។  ចូរ ទូរស័ព្ទ 1-503-362-8385 (TTY: 866-599-3376)។


ACHTUNG:  Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.  Rufnummer: 1-503-362-8385 (TTY: 866-599-3376).


ATTENTION :  Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement.  Appelez le 1-503-362-8385 (ATS: 866-599-3376).


เรียน:  ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี  โทร 1-503-362-8385 (TTY: 866-599-3376).

Silver Falls Dermatology & Allergy:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:
  • Qualified sign language interpreter
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)
  • Provides free language services to people whose primary language is not English, such as:
  • Qualified interpreters
  • Information written in other languages

Notice of Privacy Practices

Your health information includes information about your health history, health status, symptoms, examinations, test results, diagnoses, treatments, procedures, prescriptions, related billing activity and similar types of health-related information.

We are required by law to notify you about the ways in which we may use and disclose health information about you, and to describe your rights and our obligations regarding the use and disclosure of that information. Read the full notice here.

Confidential Hotline

Employees, providers, patients and teammates can report compliance concerns safely and anonymously.

  • Workplace issues
  • HIPAA and security
  • Coding compliance
  • Stark laws or anti-kickback violations
  • Any other sensitive subjects

Safe Hotline is an independent third-party service that can be used to report concerns for any of our locations. All reports received will be submitted exactly as they are received, and your identity will not be disclosed without your permission.

The hotline is easily accessed by phone, text or online. Our company code is required with every report, so that concerns can be properly directed.

Call or Text


Company Code (required)

Once a report is made, the person is given a onetime key code that can be used to check the status of the report.

The compliance hotline is not an emergency number and should not be used in place of 9-1-1.

Telephone Relay Service

Oregon Telecommunications Relay Service is a free public service for communication between standard (voice) users and persons who are deaf, hard-of-hearing, deaf-blind, and speech-disabled using text telephones (TTYs) or PCs via the Internet.

  • Voice
  • TTY
  • TeleBraille
  • Spanish
  • Voice Carry-Over
  • Speech-to-Speech
  • Hearing Carry-Over
  • 900 Toll Service
  • International Calling
  • TTY Public Payphones
  • Directory Assistance
  • Answering Machine
  • Emergency Call

If you have difficulty using the telephone, please use this HIPAA-Compliant service to communicate with our office or make appointments.

Oregon le ofrece el servicio de relevo a nuestros clientes en español. Los consumidores de TTY pueden escribir por máquina en español y las conversaciones serán retransmitidas en español y ingles.