ALS Center of Oregon
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Patient __________
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Multidisciplinary Principal Care ContinuityNew Patient AppointmentsPrior to your first visit • Please print these forms: Intake Form and Referral Form
Please return them to:
Fax: 503-494-0966 CR-120 Portland, OR 97239-3098
Returning patients are asked to please download, fill out and return the Follow-up questionnaire available on the Forms page. |
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ALS Center of Oregon Oregon Health & Science University email ALS@ohsu.edu Website comments or suggestions can be directed to Neuromuscular Webmaster phone: (503) 494-5236 fax: (503) 494-0966 Page Updated:Thursday, September 13, 2007 01:41:21 PM -0700
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