Forms
Printable Information Forms
Printable Information Forms
To save you time at your next visit to Cascade Dermatology please click on the icon to the right for printable information forms reqeusted by our office. For your convenience, Forms are provided in two file types: PDF and MS Word. If you have any questions please do not hestiate to contact us.
Please mail or fax your completed form(s) to:
Cascade Dermatology
992 Country Club Road Suite 201
Eugene, Oregon 97401
Fax: 541.345.5254
Phone: 541.485.7546
The forms below must be completed by all new patients.
Please fill out these forms and bring them with you to your appointment. You may also fax forms to: 541.345.5254.
Patient Information Form - 2 Pages 
Medical History Form - 2 Pages
Please fill out these forms if they apply to you.
If you are being seen for hairloss (Alopecia) please complete and bring with you the following form:
Hair Questionnaire
If you would like Cascade Dermatology to send your records to another physician, please complete, sign and date and either mail or fax this form to: 541.345.5254.
Release of Information form 1
If you would like your records from any physician or practice sent to Cascade Dermatology, please complete, sign and date and either mail or fax this form to: 541.345.5254.
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