This page contains numerous patient forms that you may find helpful. Filling these forms out ahead of time can help streamline your visit.
If you are seeing Dr. Korneeva or a nurse-midwife, please click here for information from Women's Healthcare Associates.
First Visit and Yearly Exam
- Patient Information Basic information we need on your first visit.
- Problem List To help you organize the things to discuss with your doctor.
- What To Expect What to expect at your first visit and your yearly examination.
- Patient Rights / Privacy Practices How medical information about you may be used and disclosed.
- Glucose Testing Directions Directions for the various Glucose tests.
- Flu Like Symptoms What to do if you are experiencing flu like symptoms.
- Cholesterol Panel Guidance on how to interpret your cholesterol test.
- Patient Satisfaction Survey We value your opinion and comments regarding our practice.
For Our Pregnant Patients
- Congratulations On Your Pregnancy! An overview of what to expect during your obstetrical care.
- If You Are Pregnant and Have a Cold What to take and when to call us.
- Food and Pregnancy Food guidelines for pregnant women.
- Mercury Exposure Fish & seafood recommendations for pregnant or nursing women.
- Pediatrician Information Recommended pediatricians in the Portland area.
- Insurance Company Questions Prenatal and delivery questions to ask your insurance company.
- Office and Financial Policies Basic billing information, referrals and discounts.
- Financial Forgiveness Policy Eligibility information and request form for financial forgiveness.
- Free or Sliding Scale Clinics Options for free or sliding scale clinics in the Portland area.