West Salem Family Practice Associates, LLC.
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Patient Forms

  • Request to become a New Patient
  • Online Bill Payment
  • New Patient Packet (Only to be completed after you have been accepted as a new patient.)
  • Patient and Insurance Information
  • HIPAA Acknowledgement Consent
  • Medical Release
  • MVA Patient Insurance Form
  • Financial Agreement
  • Dr. Thomas Annual Physical Paperwork (To be completed before your appointment.)
  • Provider Confirmation Form

Community Health Resources

  • See quality & cost scores for a doctor's office in your area

CAHPS Survey for Primary Care Providers

  • Dr. Scott Bean's CAHPS Survey
  • Amanda Mehlhoff's CAHPS Survey, FNP
  • Dr. Heidi Thomas's CAHPS Survey

1275 Wallace Rd NW ~ Salem, OR 97304 ~ 503.371.3232 ~ fax: 503-375-2398

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