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Olson Pediatric Clinic
  • Home
  • About Us
  • Services
    • Newborns
    • Well Child
    • Sick Child
    • Mental Health Services
    • Circumcision
  • Providers
    • Dr. Elizabeth Graff
    • Dr. Vinaya Pai
    • Dr. Mary Miller
    • Dr. Erik Grimm
    • Dr. Letrice Blair
  • Patient Info
    • Billing and Insurance
    • Patient Forms
    • Medicine Refills
    • Resources
  • Contact
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Patient Forms

The forms on this page are in Adobe PDF format. Please print out and complete the forms, and bring them with you to your appointment.

New Patients

Patient Registration form - Minors
New Patient History form (age 0-5 yrs)
New Patient History form (age 6-11 yrs)
New Patient History form (age 12-18 yrs)
Records Release TO Olson Pediatrics
Financial Policy

Existing Patients

Camp and Athletic participation form
Records Release FROM Olson Pediatrics
Records Release TO Olson Pediatrics
Patient Registration form - 18yrs+

OLSON PEDIATRIC CLINIC

16463 Boones Ferry Road, Ste 400
Lake Oswego, OR 97035
503.635.3743
Directions to Our Clinic

Announcements

  • DR. JEFFREY HOFFMAN RETIRED ON DECEMBER 30, 2020.
  • FLU VACCINE IS NOW AVAILABLE, CALL FOR AN APPOINTMENT.

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