Patient Forms

Thank you for entrusting Willamette Valley Cancer Institute and Research Center with your care.

Your New Patient Paperwork packet will be sent when you schedule your initial consultation. Within the packet are forms that you will need to complete and bring to your first appointment. It is important that you complete them all to the best of your ability.

The New Patient Paperwork is also available below in its entirety or as separate forms (see indented sublist). To select a form, click on a blue title below. When the form appears, type your answers in the gray "fillable" fields. You can stop at any time and save your answers to your computer, then resume later. When you've finished, save to your computer, then print out your forms.

If you prefer, you can print out the forms first, then fill them in by hand. Either way, the New Patient Paperwork forms will need to be printed, completed/signed, and brought to your first appointment. 

Please note: This website is not set up to accept secure form submission at this time. All paperwork must be printed and signed manually.

Release of Information

In order for WVCI to release a patient’s confidential medical records to a third party, the authorization form below must be completed and signed by the patient. The authorization form can be mailed, hand-delivered, or faxed to the attention of the Medical Records Department.

Gynecologic Oncology Forms

Advance Directive Forms

Media Release