Transgender Health Program Request for Service: For Patients
Use this form if you are seeking services for yourself.
(Please go to this form if you are seeking services for someone else.)
Dillehunt Hall, Room 1007
3235 S.W. Pavilion Loop
Portland, OR 97239
Dillehunt Hall can be reached through Sam Jackson Hall.
Refer a patient
- Please complete our Request for Transgender Health Services referral form and fax with relevant medical records to 503-346-6854.
- Learn more on our For Health Care Professionals page.