New Patient Forms and Information

At your first visit, be prepared to spend about 2 hours with us. This allows Dr. Sleszynski to get to know all the details of your life, explain her findings to you, make suggestions, answer your questions and help you develop a plan of care that will work for your specific circumstances and conditions.

The following letter and forms are part of the packet we prepare for new patients at Crossroads PHC. Please read these and download the forms in your choice of Microsoft Word or PDF formats. You may print out the forms, fill them out and sign them, and mail or drop them off (we have a drop box) at the office 2-3 days before your appointment to decrease your waiting time at your first visit. (Sorry, we do not accept intake forms electronically because of the risk that we may not receive the attachments correctly.)

If you can’t drop them off or mail them back, bring them with you to your visit and please be prepared to enjoy a cup of tea, a magazine and music in our living room while you wait for us to enter your information into the computer.

  • New Patient Paperwork- Download Form as: PDF
  • Ed Scott’s New Patient Paperwork – Download Form as: PDF
  • Christy Rummel’s New Patient Paperwork – Download Form as: PDF
    Thank you! Please call us at 541.207.3773 if you have any questions.