WHW Forms
Administrative Forms
We want your feedback! We love to hear when something is working well for you so we can continue doing it and where your concerns are so we can make improvements. If you would like a follow up from a director please be sure to choose that option on the form. If you would like a follow up and have not heard from a director within 10 business days please call to speak to our director Nicole Bennett at 503-729-1380.
For more information on how to inquire about therapy or medication management with our clinicians. We also offer classes and groups.
Professional Disclosure Statement
This form is for a patient or patient guardian to request their own records to be directly sent to the patient. To request records to be sent to anyone that is not the patient use the Consent for Release of Information form.
Consent Forms
Consent for Release of Information (ROI)
This form facilitates communication between Willamette Health & Wellness and other important people in your life. You may also give this form to other providers (initial the "exchange of information section") to give them permission to speak to us.
Kaiser PAR Release of Information
Outdoor Onsite Appointment Consent