Patient Resources
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Patient forms
Listed below are a complete list of forms your provider may ask you to complete and submit to us as part of your care.
ADMINISTRATIVE FORMS
We want your feedback! We love to hear when something is working well for you so we can continue doing it and where your concerns are so we can make improvements. If you would like a follow up from a director please be sure to choose that option on the form. If you would like a follow up and have not heard from a director within 10 business days please call to speak to our director Nicole Bennett at 503-729-1380.
First Visit Paperwork
Complete these forms before your first visit.
Professional Disclosure Statement
Request Your Medical Records
This form is for a patient or patient guardian to request their own records to be directly sent to the patient. To request records to be sent to anyone that is not the patient use the
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CONSENT FORMS
CONSENT FOR RELEASE OF INFORMATION (ROI)
This form facilitates communication between Willamette Health & Wellness and other important people in your life. You may also give this form to other providers (initial the "exchange of information section") to give them permission to speak to us.
Kaiser Par Authorization to Disclose Records
Outdoor Onsite Appointment Consent
Revocation of Release of Information (ROI)
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CLINICAL FORMS
Only complete the below forms if your provider asks you to do so.
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Educational Resources
GENERAL MENTAL HEALTH AND MEDICATION INFORMATION
Agency for Healthcare Research and Quality. This consumer page provides information for patients about prevention, diagnosis and treatment of health and mental health issues.
UpToDate. Online resource to learn more about your medical condition and explore your treatment options.
Patients Like Me. A site for mood and medication tracking as well as community discussions about health and mental health issues.
Oregon Center of Excellence for Behavioral Health & Aging. A center that addresses growing mental health and substance use disorders among older adults.
National Institute of Mental Health. Mental health advocacy and information site for adults and children.
MGH Center for Women's Mental Health. Massachusetts General Hospital Center for Women’s Mental Health, a perinatal and reproductive psychiatry information center.
1-833-975-0505 Oregon Number for Referrals to Housing, Behavioral Health, and Substance Use. A resource for substance use screening, service referrals, and to more efficiently connect individuals with substance use treatment, housing, and overdose prevention providers within the statewide behavioral health resource networks (BHRNs).
Exercise is Medicine. A global health initiative managed by the American College of Sports Medicine (ACSM) to make physical activity assessment and promotion a standard in clinical care, connecting health care with evidence-based physical activity resources for people everywhere and of all abilities.
The Mental Health Benefits of Exercise
Crisis Line for Racial Equity Support: 503-575-3764. It is answered by BIPOC counselors Mon-Fri from 8:30 AM -5:00 PM.
Local mental health resources and events
Abraham Low’s Self Help Systems. Formerly known as Recovery Inc. A self-help group using Cognitive Behavioral methods to manage anxiety and depression.
MEDICATION ASSISTANCE
GENERAL MENTAL HEALTH INFORMATION FOR FAMILIES
American Academy of Child & Adolescent Psychiatry. Helpful information for families about specific mental health issues and treatment.
NAMI of Oregon. A statewide grassroots organization dedicated to improving the quality of life for individuals with mental illness and their families through FREE education classes, FREE groups, advocacy, and legislative changes affecting individuals with mental illness.
Reach Out Oregon - Warm Line. Oregon Family Support Network (OFSN) recently launched a new website for its Reach Out Oregon Warm Line with additional resources. Reach Out Oregon is focused on promoting mental, behavioral, and emotional wellness through education, support, and advocacy. The warm line is a great resource for parents and families to receive support through phone, text, or chat. Additional resources such as trainings and discussion boards are also available through the website.
Watch: Rethinking Challenging Kids — Where There’s a Will There’s a Way. Ted Talk by J. Stuart Ablon
Listen: When Your Child Doesn’t Participate in Therapy by Robyn Gobbel. Includes a podcast and infograph.
AUTISM
Autism Society of Oregon. The Autism Society of Oregon's goals are to increase awareness of needs, interests, problems, and solutions for people living with autism across a lifespan.
Autistic Self Advocacy Network. A self-advocacy organization which seeks to advance the principles of the disability rights movement with regard to autism.
Autism Speaks. Awareness and advocacy organization.
SOCIAL MEDIA INFORMATION FOR PARENTS
RECOMMENDED READING
Browse our collection of recommendation mental health books here:
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Browse anti-racist staff book club reading list here:
ADDITIONAL RESOURCES IF WE'RE UNABLE TO ASSIST YOU
Portland Behavioral Mental Health Unit. A helpful resource to connect you to other mental health providers.
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WHW Recommended Resources for Children (PDF)
Our trusted partners
We believe provider fit is the foundation of exceptional mental health care. In the instance where we are unable to meet your needs, we can confidently recommend any of the practices listed below. We work with each practice regularly and are confident in the values and quality of care.
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Please contact them directly to check their availability and insurance coverage.