Office Forms

Our office forms are in PDF format and will open in a new browser window. In order to open and print them out, you will need to have Adobe Reader on your computer. If you do not have Adobe Reader, you may download it for free.

Click this image to go to the Adobe website to download the free Reader:

If you or your child are seeing us for the very first time, you may save time by opening these forms, printing and filling them out and bringing them with you to your first appointment.

Please be aware that some of these forms will take a minute or more to open fully in your browser window, particularly on dial up connections. They may "flicker" on your screen as they are opening but once they have finished downloading they will display correctly.

Patient Information Form: Established patients may also use this form to notify us of a change in address, phone number, etc.

Initial History Questionaire: New patients should fill out this form and bring it with them to their first appointment.

Authorization / Consent Form: Use this form to indicate names of persons who may bring your child/children to The Children's Clinic for care, and to whom information and instructions may be given.

Children's Clinic of Klamath Office Policies:
Financial Policy
No-Show Policy
Privacy Policy and Patient Notification of Non-Covered Services.

Release of Information Authorization Form

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