New Research Patient Forms

Thank you for scheduling your research screening appointment with Oregon Dermatology and Research Center!

During your initial research screening visit, one of our research coordinators will complete a full medical history intake with you.  If you have a patient portal with your primary care provider's office, we recommend printing off your medical history and medication summary to facilitate the intake with our research staff. If you are unable to print off a medical and medication summary from your primary care provider's patient portal, please bring a list of your current medication(s) with the following information: name, dosage, unit, and the amount taken per day.

Click on the link below to download the form:

Notice of Privacy Practices_Acknowledgment Form