We're excited to serve you!
Thank you for choosing us! If you would like to establish care at our new clinic, please fill out a new patient inquiry form here and we will be in touch. We look forward to serving you and your family.
Transferring Your Patient Records
For Salem Health Patients
- You do not need to request your records directly from Salem Health, our clinic is working with Salem Health to request your records to be transitioned to the new clinic. Please note, this will only happen once you have registered and scheduled for an appointment with our clinic.
For patients at other clinics, please follow these steps:
- Complete a release of records form from your current/previous provider
- These are often called a “Release of Information” or “Release of Protected Health Information” form
- On the records request please request the following:
- Fax to:
- Fax: (971) 612-6101
- Praxis Health – Dallas Family Care
- 531 SE Clay St Dallas OR 97338
- Phone: (971) 612-6100
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- The last visit for the following:
- Clinic/Office Notes
- History/Physical
- Imaging
- Immunization Records
- Lab/Pathology Reports
- Radiology Reports
- Medication List & Allergy List
Getting Ready for Your Visit
In order for us to provide the best care for you, it is very important that you bring the following items to your visit:
- Photo ID
- A list of your current medications
- Any and all x-rays films
- Insurance information and card
- Information about what treatments and medications have been tried in the past
- Medical records from prior visits that you think may be helpful
- New Patients: download our patient registration form below
Download Patient Forms
To view the forms listed below, you will need to download Adobe Reader. Please bring your completed forms with you to our office at the time of your visit.
Q-Corp Clinic Scorecard
(971) 612-6101 