Patient Registration

Here’s an easy way to start:

1. Fill out our Patient Registration Form.
2. Fill out our Health History Form.
3. Please read the Notice of Privacy Policies (Spanish Version).
4. Fill out our medical records release form.
5. For minors,  parents may want to fill out a parental preauthorization for medical care for children.

If you’re unable to start the process on-line, no worries. Just come in 20 minutes early for your appointment so you have time to fill out the forms in our clinic.

So you know ahead of time, here’s the information you’ll need to provide when you register with us:

Your full legal name, including maiden name and nickname(s)

  • Your street address, and home and work telephone numbers (or address and telephone numbers for the parents or guardians of minor children)
  • Your Social Security number
  • Your birth date
  • Your health insurance information
  • Your photo ID
  • Your Medicaid or Medicare card (if you have one)
  • The contact information for the person responsible for payments (if you don’t have insurance)
  • Any special needs you may have (interpreter, wheelchair access, etc.)
  • The date and type of injury (if you were involved in an accident while at work)
  • Medications you’re taking (prescriptions, over-the-counter drugs, vitamins or supplements)
  • Any known drug allergies you may have
  • Any healthcare concerns you have

And here are the documents you’ll need to bring with you:

Insurance card

  • Medicaid/Medicare card

  • Co-payment or pre-payment (We accept cash, personal checks, VISA debit cards, Discover, MasterCard or VISA)
Other information you should send beforehand:

  • Medical records and X-rays
If you are being referred to us from a non-BMC clinic, we ask that you please send your medical records and related X-rays to us before your appointment. For more information on this, call 541-317-4367.

Insurance Information
Generally, we will bill your primary and secondary insurance for you. Once your insurance is billed, you are responsible for any amount not covered by your insurance.

We accept a wide range of insurance plans and are part of the medical networks listed below. This list is not all-inclusive, so if your plan or network is not listed below, give us a call them to see if your plan or network is accepted.

Insurance plans and medical networks covered by BMC:
 

  • Regence BlueCross BlueShield of Oregon (access to only PAR options)

  • ODS Health Plan 

  • Pacific Source
  • HealthNet of Oregon 

  • PacifiCare
  • Providence Health Plan
  • Providence Preferred/Select 

  • LifeWise Health Plan PacifiCare
  • Providence Select PP0 

  • Healthcare Direct
  • Employers Health Association

  • QVI 

  • PHP

  • Clear Choice Health Plans

  • Worker's Comp

If you have any insurance or payment questions, we’d be happy to talk with you. Just give us a call at 541-317-4200.