Patient Information 2017-12-06T11:52:37+00:00

Patient Information and Forms

Welcome and thank you for choosing Bridgeview Women’s Health. Please review the following patient information prior to your first appointment.

Registration Forms

Please download the following printable forms, fill them out completely, and bring them with you to your first appointment. If you are unable to download them, please call our office at (503) 274-4800 and ask for them to be mailed to you.

Welcome Letter (.pdf)
Health History Questionnaire (.pdf)
Medications List (.pdf)
Genetics Questionnaire (.pdf)
Release of Verbal Medical Information (.pdf)
Release of Records Authorization (.pdf)

You may also wish to review Legacy Good Samaritan’s Maternity Guide.


We accept most common forms of insurance, including Oregon Health Plan and Medicare. You will need to bring your insurance card to each appointment. Our office staff will take a copy of this card for billing purposes. Patients without an insurance card or Proof of Insurance (letter from employer including patient name, ID number, group number, claims address and insurance phone number) will be required to pay at the time of service.

Prescription Refills

Please call your pharmacy for refills of your prescriptions. This allows for faster and more accurate service. You may also call our prescription refill line at 503.423.9368 and leave your refill information. We only refill prescriptions during business hours, Monday through Friday 9:00am to 5:00pm. Please allow up to 48-72 hours for processing.

Cancellation Policy

We ask that you notify us as early as possible if you are unable to attend your scheduled visit. This will allow us to fill the appointment time with another patient from our waiting list. For appointments that are not kept and not cancelled, Bridgeview Women’s Health charges a $20.00 “no show” fee. Patients are required to pay this fee prior to being seen for their next appointment.

Privacy Policy

Your privacy as a patient is extremely important to us. If you are concerned about how your medical information may be used by our office, please take a minute to review our privacy policy.