Patient Portal

PATIENT REGISTRATION FORMS

We ask that all new patients download, print and complete a patient registration packet before arriving for your appointment. Reviewing your registration packet in the comfort of your own home is more convenient for you and allows sufficient time to complete some of the more detailed sections.

Please bring all forms with you to your appointment. Should you have any questions, our staff will be happy to assist while completing your registration.

PDFs: You will need Adobe Acrobat Reader to view and print PDF forms. If you do not have this program, you may download it for free here.

Download a Patient Registration packet for:

• Dr. Husum (PDF)
• Dr. Fernando Cendejas (PDF)
• Dr. Linden (PDF)
• Dr. Blanche (PDF)
• Dr. Newton (PDF)
• Dr. Mendoza (PDF)
• Jaymey Sweeney, FNP (PDF)

POLICIES

To our valued patients:

In order to provide you with our full time and attention when you come for an appointment, we would like to ask you to be aware of the following guidelines that help us to help you.

Prescription Refills:

• We are implementing a new, state of the art, e-prescribing system. This works best if you call your pharmacy directly for any prescription refills, even if you have no refills left. The pharmacy will contact us directly to get approval for a new prescription.

  • Please plan ahead as most local pharmacies request 2-3 business days for prescription refills. If there are no refills left on your prescription, this allows time for the pharmacy to get our approval to refill your medication.

  • We realize emergencies happen, but ask you to call our office, and not come to the office requesting an emergency refill. This interrupts the care we give patients who are scheduled to be seen. Pharmacies will typically give you a 2-3 day supply of any non-narcotic medication if you run out without realizing it, and need time for them to process a refill.

  • For mail order prescriptions, please contact your pharmacy for refills via their 800 number or website. Please be sure to contact your pharmacy at least 2 weeks before you will need the refill. If it is necessary for us to complete forms for your mail order pharmacy please give us 3 business days to complete the paperwork and have it ready for you. If you call to request a mail in prescription refill by phone, please have your pharmacy benefit ID # (located on your insurance card) ready to give to our staff.

  • Many drug plans will not cover brand name medications, or do so at a much higher cost. We are not always able to obtain prior authorizations for your medications. Generally, you can expect to receive generic medications or pay a higher cost if you prefer the brand name drugs.

Walk-in appointments:

• We almost always have same day appointments available for urgent needs. Please call ahead of time to schedule an appointment instead of arriving at our office and requesting to see the physician or nurse practitioner, as walk-ins impact our ability to see scheduled patients on time.

Test results:

• We will notify you regarding all lab results either at your appointment, or by phone or mail.
• If you have not been contacted with your results two weeks after your appointment, please call our office to follow up.
• Pathology reports, pap smears, and bone density results may take up to four weeks. Please call our office if you have not been contacted after four weeks.

Diagnostic screening:

• X-rays (done at RVP) generally available on a same day basis.
• CT scans (done at RVP) most require insurance pre-authorization if not an emergent exam. This may take 2-3 days.
• MRI, PET, Nuclear Medicine, sleep studies, cardiac studies, and other diagnostic tests- most require insurance pre-authorization if not an emergent exam. You will be referred to outside facilities for these studies. We contact the imaging facility of your choice, and they will contact you to schedule an appointment. This can take a week or longer to process. If you have not been contacted after two weeks, please call our office to request assistance in getting your exam scheduled.

Copies of lab results or radiology reports:

• We are happy to provide you with your most recent lab or radiology reports. Please call ahead and give us 3 business days to complete your request. Your reports will be available for pick up at our reception desk or can be mailed to you at the address of record in our files.
• See below for information on obtaining copies of medical records.

Financial Policy:

Thank you for choosing Southern Oregon Internal Medicine for your health care needs. Please view our Financial Policy Statement (PDF) which we request that you read and sign prior to your visit with us.

We appreciate you choosing Southern Oregon Internal Medicine for your health care needs, and appreciate your cooperation with our office guidelines. Our goal is to make sure that every patient receives timely focused care. We also want to ensure that we take care of your other needs and requests as they come up. Thank you.

Copies of Medical records:

• If you would like a copy of your complete medical record, we will need a formal request from you, which must be completed in writing and signed by you or your authorized representative. For your convenience a Medical Release form PDF* can be downloaded and submitted via fax or to the address included on the form.
• Please allow 30 days for medical record requests. There is a small copying charge.

PDFs: You will need Adobe Acrobat Reader to view and print PDF forms. If you do not have this program, you may download it for free here.

Download a Medical Release form here:

• Dr. Husum Medical Release form (PDF)
• Dr. Cendejas Medical Release form (PDF)
• Dr. Linden Medical Release form (PDF)
• Dr. Blanche Medical Release form (PDF)
• Dr. Newton Medical Release form (PDF)
• Dr. Mendoza Medical Release form (PDF)
• Jaymey Sweeney, FNP Medical Release form (PDF)
  
  

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