Patient Info

Advance Directive
Advance Directive Form
As long as you can speak for yourself, you are always in charge of your health care. But what happens if accident, illness or disability robs you of the ability to make your wishes known? You can take action now to insure your wishes are followed when you can't speak for yourself by filling out an Advance Directive for Health care. Ask your provider for a booklet that contains a legal form which allows you to express your wishes for care, if you become unable to decide in the future.
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Advance Directive Q & A

1. What does an Advance Directive do?

  • • This form lets you choose a health care representative that can make health care decisions for you only if you cannot.
  • • Your health care representative must agree to represent you and this person must sign the form.
  • • The form lets you give directions to your representative for care if you cannot make health care decisions for yourself. For example:
    • • If you are terminally ill
    • • You are permanently unconscious.
    • • You are in an advanced stage of progressive, fatal illness.

2. Who should complete an Advance Directive?

  • • In Oregon, any one over the age of 18 may complete an Advance Directive.
  • • It is especially important when you are ill and seeking medical care.

3. Where does the Advance Directive live in the medical record?

  • • The Advance Directive is scanned in to your electronic medical record as document that is accessible to clinical staff.
  • • There are certain fields in the electronic medical record that indicate to the doctor or staff when you have an Advance Directive on file, when you’ve been given an Advance Directive to complete and when it has been returned.

4. Should there be copies of the Advance Directive kept in other places?

  • • Keep the originals in a safe but easily accessible place.
  • • Give a copy to your doctor.
  • • Give a copy to your health care agent and any alternate agents.
  • • Keep a record of who has your advance directives.
  • • Talk to family members and other important people in your life about your advance directives and your health care wishes.
  • • Carry a wallet-sized card that indicates you have advance directives, identifies your health care agent, and states where a copy of your directives can be found. This is available at any Portland Clinic office.

5. How does communication take place regarding the Advance Directive when travelling?

  • • You should keep a copy of your Advance Directive with you when travelling.

6. Who can access the Advance Directive?

  • • Your Portland Clinic doctors and staff can access the scanned copy of your Advance Directive in your electronic health record.

7. How do I know when the Advance Directive is completed correctly?

  • • Review your advance directives with your doctor and your health care agent to be sure you have filled out forms correctly

8. How and when should I talk to my physician about Advance Directives?

  • • You can make an appointment to speak to your doctor regarding your Advance Directive at any time.
  • • You can submit a completed form to your doctor or a clinical staff member at any time.
  • • Make sure your doctor understands and supports your wishes.

9. Why should I have an Advance Directive?

  • • Advance directives are a way to protect your rights as a patient.
  • • It is your right to make decisions about your medical care, including the right to accept or to refuse medical or surgical treatment. If, however, through sickness or injury you become unable to make informed decisions about your medical care-including whether to accept or refuse treatment – an Advance Directive would help your healthcare providers and family to know your wishes.

10. How important is the Advance Directive?

  • • As a patient, you have the right to make your own informed decisions about medical care and to communicate these decisions to healthcare providers.
  • • An advance directive can express both what you want and don’t want.

11. Is the Advance Directive a binding legal document?

  • • Yes, but meaningful discussion with your doctor and family is actually the most important step. The question of what is “legally effective” is misleading, because even a legally effective document does not automatically carry out your wishes.

12. Can the Advance Directive worksheet be simplified?

  • • No. The Advance Directive is a form that has been adopted under Oregon law.

13. What in-person patient resources are available to assist with the Advance Directive process?

  • • Your physician, nurse practitioner, or physician assistant can talk with you about advance directives and about your care options.

14. How is the fact that I have an Advance Directive communicated in the medical community? (i.e., between Primary Care Physician and Emergency Room).

  • • The Advance Directive will not be effective in the event of a medical emergency. Ambulance and hospital emergency department personnel are required to provide cardiopulmonary resuscitation (CPR) unless they are given a separate directive that states otherwise. These directives called “prehospital medical care directives” or “do not resuscitate orders” are designed for people whose poor health gives them little chance of benefiting from CPR. These directives instruct ambulance and hospital emergency personnel not to attempt CPR if your heart or breathing should stop.
  • • Oregon authorizes a special order, called a Physician Order for Life-Sustaining Treatment ("POLST"), that can be registered with the state to ensure that your out-of-hospital, end of life treatment preferences are honored. More information can be found at: http://www.or.polst.org/resources/

15. Is it possible to access my Advance Directive through MyChart?

  • • It is not possible to access your Advance Directive through MyChart currently, but The Portland Clinic hopes to have this capability in the future.
Appointment Information
Important phone numbers

THE PORTLAND CLINIC- BEAVERTON
15950 SW Millikan Way
Beaverton, OR 97003
(503) 646-0161
Mon-Thur, 7:30 a.m. – 5 p.m., Fri, 8 a.m. – 5 p.m.

THE PORTLAND CLINIC- COLUMBIA
5847 NE 122nd Avenue
Portland, OR 97230
(503) 256-3401
Mon. - Fri., 7:30 a.m. - 5 p.m.

THE PORTLAND CLINIC- DOWNTOWN
800 SW 13th Avenue
Portland, OR 97205
(503) 221-0161
Mon. - Fri., 8 a.m.- 5 p.m. (Scheduled Appointments)
Mon. - Fri., 9 a.m. - 6 p.m. (Walk-in Urgent Care, 16 and older)

THE PORTLAND CLINIC- EAST
541 NE 20th Ave, Suite 210
Portland, OR 97232
(503) 233-6940
Mon. - Fri., 7:30 a.m. – 5 p.m.

THE PORTLAND CLINIC- HILLSBORO
256 SE 2nd Ave
Hillsboro, OR 97123
(503) 648-4171
Mon. - Fri., 8 a.m.- 5 p.m.

THE PORTLAND CLINIC- SOUTH
6640 SW Redwood Lane
Portland, OR 97224
(503) 620-7358
Mon. - Fri., 7:30 a.m.- 5 p.m.

THE PORTLAND CLINIC- TIGARD
9250 SW Hall Boulevard
Tigard, OR 97223
(503) 293-0161
Mon.- Fri., 8 a.m. - 5 p.m. (Scheduled Appointments)
Mon.- Fri., 8 a.m. - 8 p.m. (Urgent Care)
Sat., 9 a.m. - 5 p.m. (Urgent Care)

ALBERTY SURGICAL CENTER
9100 SW Oleson Road
Tigard, OR 97223
(503) 445-9066
Mon.- Fri., 8 a.m. - 5 p.m. (Scheduled Appointments)

THE PORTLAND CLINIC EYE SERVICES - DOWNTOWN OFFICE
800 SW 13th Avenue
Portland, OR 97205
(503) 227-0354
Mon. - Fri., 8 a.m.- 5 p.m.

THE PORTLAND CLINIC EYE SERVICES - BEAVERTON OFFICE
15950 SW Millikan Way
Beaverton,OR 97006
(503) 643-1166
Mon. - Fri., 8 a.m.- 5 p.m.

THE PORTLAND CLINIC EYE SERVICES - SOUTH OFFICE
6640 SW Redwood Lane
Portland, OR 97224
(503) 924-2269
Mon. - Fri., 8 a.m.- 5 p.m.

TOLL-FREE FROM SOUTHWEST WASHINGTON (360) 693-3532

AFTER HOURS
For urgent needs when our clinics are closed, call our on-call physician:(503) 221-0161

SCHEDULING/PHYSICIAN REFERRAL
For direct-line scheduling or to receive a list of primary care physicians and their biographical data:
(503) 223-3113

QUESTIONS (Bills/Authorizations/Claims & Patient bills, statements and accounts)
(503) 221-2189

REFERRALS OR PRIOR-AUTHORIZATIONS
(503) 221-2199

Does The Portland Clinic have extended office hours?
Yes. The Portland Clinic- Tigard offers walk-in Urgent Care 6 days a week (M-F, 8am-8pm, Sat 9am-5pm) and our Downtown location offers Urgent Care, M-F, 9am-6pm (16 yrs and older). For a complete listing of our office hours visit Important Phone Numbers.
Do you provide parking at all of your locations?
Parking at all of our facilities is conveniently located right next to the buildings. There is a small 75 cent per hour charge for parking at our downtown location to cover the cost of the parking attendant. Our Beaverton, Columbia, East, Hillsboro, South, and Tigard locations provide free parking.
How can Portland Clinic patients reach a physician after hours?
For after hours care, just call our main office phone number, (503) 221-0161, and we will have one of our physicians contact you.
Preventative Health Care Guidelines

The following guidelines are designed for the healthy patient without medical problems. These are our recommendations for routine exams, tests, counseling and vaccinations designed to keep you at the best health possible. They are based on the U.S. Preventive Services Task Force recommendations, Center for Disease Control, and many other national and local resources.


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Authorization to Verbally Disclose Protected Health Information (PHI)
Download the Authorization to Verbally Disclose Protected Health Information (PHI)
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Billing Brochure
Understanding Health Expenses
This brochure will help answer some of your questions about medical expenses.
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Class Registration Information
Register for Health Classes

Hot Topics in Diabetes. To register, call (503) 620-7358 ext 2951 or RSVP@tcpllp.com

Rev it Up! To register, call (503) 223-3113 or RSVP@tcpllp.com

Diabetes: Invitation to a healthier life. To register, call (503) 223-3113 or RSVP@tcpllp.com

Making Healthy Changes to Avoid Diabetes. To register, call (503) 233-6940 or RSVP@tcpllp.com

Insurance Information
Medicare Services

Dear Patient:

The Portland Clinic wants to let you know which Medicare Advantage plans our doctors are accepting for the year 2016. We understand that selecting a Medicare plan can be confusing, so we have partnered with SeniorChoices NW, a local agency specializing in Medicare approved HMO, PPO, and PDP insurance plans. At no cost to you, SeniorChoices NW (at 503-682-1878, TTY 711 9:00 a.m.-5:00 p.m. Monday – Friday) can assist you in selecting the plan that fits your needs while enabling you to continue to see the doctors at The Portland Clinic. We encourage you to attend one of the free Medicare Informational Meetings we are holding in the upcoming months. A sales person from SeniorChoices NW will be present with information and applications. The meeting locations, dates and times are listed on the back of this letter.

Starting 01/01/2016 – Neither our PCP’s nor Specialists (all Providers) will be accepting new or age-in (turning 65) patients on Original Medicare. Age-ins will need to choose a Contracted MedAdvantage Plan. Our PCP’s and Specialists (all Providers) will continue to accept our “current” patients who have been on Original Medicare in 2015. Please contact Senior Choices NW for assistance.

As of 01/01/2017 The Portland Clinic Providers will no longer be accepting new or existing patients with Original Medicare and a Medicare Supplement plan also known as a Medigap (i.e. Plan F). We urge our Medicare patients to choose or change to one of the following Medicare Advantage plans.

The Portland Clinic doctors are accepting the Medicare Advantage plans below for 2016. These insurance companies offer full Medicare benefits plus extra benefits beyond Original Medicare. If you’re on one of the following Medicare Advantage Plans and do not want to change, please disregard this informational letter.

  •  AARP® MedicareComplete® by UnitedHealthcare HMO Plans Only (Columbia & Hillsboro Office Providers Closed to UnitedHealthcare HMO’s)
  •  Health Net® Medicare Plans
  •  Kaiser Permanente® Medicare Advantage Plans – Contact Kaiser Permanente Directly
  •  Portland Coordinated Care and PacificSource – Medicare’s MyCare RX 22 (HMO) Plan
  •  Providence Medicare Advantage Plans
  •  Regence MedAdvantage Plans

You may already be aware that Medicare Advantage plans renew their contracts and change benefits every year. Any changes to your current Medicare Advantage plan for 2016 must be made between October 15th and December 7th. (Special Enrollment Periods are still in effect for qualifying events.)

If you have additional questions that are not answered after you’ve contacted SeniorChoices NW, please call Marilyn Downing, Medicare Health Plan Advisor for The Portland Clinic at 503-221-0161 Ext. 2128. TTY users should call TTY 711 8:00 a.m.-5:00 p.m. We appreciate your loyalty and will continue our 94-year tradition of providing quality medical care to you and your family.

Sincerely,

Marilyn Downing, Medicare Health Plan Advisor

H9047_2016TPC01

THE PORTLAND CLINIC FREE MEDICARE INFORMATIONAL MEETINGS

  • Beaverton Office
  • 15950 SW Millikan Way, Beaverton, OR 97006
  • Employee Lounge Room
  • 2:00 pm to 3:30 pm
  • January 1 – September 30, 2016
  • Last Monday of every Month except Memorial Day
  • October 15 – December 7, 2015
  • Every Monday

  • Columbia Office
  • 5847 NE 122nd Avenue, Portland, OR 97230
  • Conference Room
  • 1:30 pm to 3:00 pm
  • January 1 – September 30, 2016
  • Last Thursday of every Month
  • October 15 – December 7, 2015
  • Every Thursday Except for Thanksgiving

  • Downtown Office - Yamhill Plaza
  • 1221 SW Yamhill, Portland, OR 97205
  • 4th Floor, Suite 4 - Conference Room 2
  • Free Parking in the lot at The Portland Clinic
  • 10 am to 11:30 am
  • January 1 – September 30, 2016
  • Last Friday of every Month
  • October 15 – December 7, 2015
  • Every Friday except the Friday after Thanksgiving

  • East Office
  • 541 NE 20th Ave., Ste. 210, Portland, OR 97232
  • Conference Room
  • 10 am to 11:30 am
  • January 1 – September 30, 2016
  • Last Thursday of every Month
  • October 15 – December 7, 2015
  • Every Thursday Except for Thanksgiving

  • South Office
  • 6640 SW Redwood Lane, Portland, OR 97224
  • Conference Room 2nd Floor
  • 10 am to 11:30 am
  • January 1 – September 30, 2016
  • Last Tuesday of Every Month
  • October 15 – December 7, 2015
  • Every Tuesday

For accommodation of persons with special needs at sales meetings, call 503-682-1878 (TTY: 711) 9:00 a.m. to 5:00 p.m., Monday–Friday, Pacific Time. Please call SeniorChoices NW at 503-682-1878 and you will be directed to a licensed independent insurance agent familiar with all the plans our clinics accept.

What is the Health Exchange?
As of November 15, 2014, anyone wanting to enroll in health insurance through the exchange will need to use the federal website at: www.healthcare.gov, as the Cover Oregon website will no longer be taking enrollment applications. The Health Exchange Marketplace is mandated for all states based on the Affordable Care Act which was passed into law in 2010 and goes into effect in 2014. The law requires most people who can afford health insurance to have coverage or otherwise, pay a penalty.
Participating Health Plans

Oregon's Health Exchange

The Portland Clinic will be participating with the following health plans through the Health Insurance Exchange:

  • PacificSource
  • Kaiser Permanente
  • Lifewise
  • Moda Health
  • Providence Signature (previously known as Providence EPO) & Providence Choice
  • Oregon Health CO-OP Broad Plan (only)

PARTICIPATING HEALTH PLANS

  • Aetna
  • Assurant Health
  • Caremark PPO
  • Choice Care
  • Humana PPO
  • Cigna
  • First Choice Health
  • First Health Network
  • Fortis Health
  • Great West Healthcare
  • GEHA
  • Guardian
  • HMA (Healthcare Management Administrators)
  • Health Net of Oregon
  • - HMO
  • - PPO
  • - Community Care
  • - MedAdvantage PPO & HMO
  • Health Republic Insurance
  • Kaiser Permanente
  • - Individuals and Families
  • - Senior Advantage (HMO)
  • - Added Choice (Tier 1)
  • - Connected Care
  • - Commercial
  • Legacy Employee Health Plan (UMR) - Can be seen through 3/31/16
  • Lifewise of Oregon
  • Medicare (accepting established The Portland Clinic patients only)
  • Video: The Portland Clinic: Medicare Advantage
  • MHN (Managed Health Care NW)
  • Moda Health (formerly ODS)
  • Multiplan
  • Motor Vehicle
  • Oregon Health CO-OP Broad Plan
  • PacifiCare of Oregon
  • PacificSource
  • - PacificSource Smart Health
  • - PacificSource Student Health
  • Portland Coordinated Care and PacificSource – Medicare’s MyCare RX 22 (HMO) Plan
  • Providence
  • - Providence Health Plans of Oregon
  • - Providence Preferred
  • - Providence EPO
  • - Providence Choice
  • - Providence Medicare Extra
  • Regence BCBS of Oregon
  • - Participating (PAR) Network
  • - Preferred Provider Plan (PPP) Network
  • - Access Network
  • - MedAdvantage PPO
  • - BlueAdvantage HMO
  • - OSN Prov & OSN Legacy
  • - Blue Card
  • - Federal
  • UHC AARP MedicareComplete HMO – closed to Columbia & Hillsboro
  • United Healthcare
  • Workers Comp

To view a list of our senior plans that we accept, please see Medicare Services.

If your insurance plan is not listed, we may still accept it. Call our business office at (503) 221-2189 to check.

What plans through the Health Exchange will The Portland Clinic be accepting in 2015?
PacificSource, Kaiser Permanente, Health Net, Lifewise, Moda Health, Providence EPO and Providence Choice, Health Republic, and Oregon Health CO-OP Broad Plan
If I have insurance through my employer, will the exchange affect me?
Employer based insurance will continue and you will not need to purchase insurance through the health exchange. The health exchange is for individuals who purchase their own insurance.
If I already have an individual policy that I like, do I need to make any changes?
Most policies are going away January 1, 2014, which will require you to find a new policy that complies with federal law. The deadline for people in the individual market to enroll is March 31, 2014. However, since most policies are going away January 1, you should try to be enrolled by the start of 2014.
Lab Results
More information here

Brief Explanation of Laboratory Blood Tests

Glucose (Glu)
Glucose (Glu) is a measure of the sugar level in your blood. The glucose reference range is for patients who are fasting at the time their blood is drawn. High values may be associated with having eaten just before the test of with diabetes.

Sodium (Na) and Chloride (Cl)
Sodium (Na) and Chloride (Cl) are essential elements regulated by diet, the kidneys, and adrenal glands. They are important for the functioning of nerves, muscles and most cells.

Potassium (K)
Potassium (K) is another essential element. It is controlled very carefully by diet and by the kidneys. It is important for the functioning of nerves and muscles, particularly the heart. Any value outside the expected range, high or low, requires medical evaluation. This is especially important for if you are taking a water pill or heart pill such as furosemide (Lasix) or digoxin (Lanoxin).

Blood Urea Nitrogen (BUN)
Blood Urea Nitrogen (BUN) is a nitrogen containing waste product produced in the liver and excreted by the kidneys. High values may mean that the kidneys are not working as well as they should. BUN is also increased by high protein diets and/or strenuous exercise.

Creatinine (Creat)
Creatinine (Creat) is another waste product. It is also an indicator of kidney function. The amount present is not greatly affected by diet. High values require medical evaluation, especially with high BUN levels. Low values are generally not significant.

Uric Acid
Uric Acid, a waste product, is normally excreted in urine. High values are associated with a rich diet, gout, arthritis, kidney problems and the use of some diuretics. Low values are generally not significant.

Calcium (Ca) and Phosporus (Phos)
Calcium (Ca) and Phosporus (Phos) levels are controlled by the parathyroid glands and the kidneys. These minerals are found in bones and teeth, but are also important for normal cellular activity.

Cholesterol (Chol)
Cholesterol (Chol) is used as one indicator to estimate the risk of developing heart disease. Several forms of cholesterol may be reported. Total and HDL cholesterol levels are measured. Other cholesterol levels are usually calculated from these results. Current guidelines recommend the total cholesterol be maintained below 200mg/dL, HDL cholesterol (good cholesterol) should be above 40mg/dL and LDL cholesterol should be below 130 mg/dL. Patients with increased risk factors for heart disease may have recommended values that are more stringent.

Triglycerides (Trig)
Triglycerides (Trig) are the fats in your body. There are many kinds of fats, but most belong to the group called triglycerides. In order for this test to be accurately interpreted, you must not have eaten (fasted) for 12 - 16 hours before your blood is drawn. The desirable level for triglycerides is below 150mg/dL, but may vary with age, diet and coronary disease risk factors.

Total Protein
Total Protein is the combined values of the two proteins, albumin and globulin. Albumin (Ab) and Globulin Albumin (Ab) and Globulin are the two types of protein in your blood. They are a useful index of overall health and nutrition. Globulin contains the antibody proteins important for fighting disease.

Bilirubin (Bili)
Bilirubin (Bili) is the primary pigment in bile from the liver. Although low levels are generally not significant, high bilirubin values may indicate liver disease or some other disorder that reduces the normal flow of bile, or produces an increase in bilirubin itself. It may be increase with certain anemias.

Alkaline Phosphatase (ALP)
Alkaline Phosphatase (ALP) is an enzyme found in high levels in liver and bone and is useful in detecting disease of these organs. Low values are probably not significant.

AST
AST is an abbreviation of an enzyme that aids various chemical activities within cells. Injury to these cells releases this enzyme into the blood. It is found in muscles, the liver and the heart. Damage to cells from alcohol and a number of diseases are reflected in high values. Low values are generally insignificant.

ALT
ALT is an abbreviation for an enzyme found mainly in the liver. It is usually used to check for liver damage or disease.

Glomular Filtration Rate (GFR)
Glomular Filtration Rate (GFR) is a calculated value that is an indicator of kidney function. % Hemoglobin A1c (%HbA1c) % Hemoglobin A1c (%HbA1c) is used as an indicator of the average blood sugar over the past two months. The Estimated Average Glucose (eAG) is calculated from the %HbA1c, and is, as the name implies, an estimation of the average glucose level, in mg/dL, during the past two months.

Prostate Specific Antigen (PSA)
Prostate Specific Antigen (PSA) is a protein that is found almost exclusively in the male prostate gland, which is located next to the bladder. It is normally found at low levels in men, but increases in some normal (benign) conditions and also in adenocarcinoma (cancer) of the prostate gland. It is used to detect cancer (screening) and to monitor patients who are being treated for cancer.

Thyroid Stimulating Hormone (TSH)
Thyroid Stimulating Hormone (TSH) is a hormone produced by the anterior pituitary gland. It stimulates the production of active thyroid hormones. This regulatory hormone is a very sensitive indicator of normal thyroid function and is frequently used as a screening test for over or under active thyroid function. A high TSH may indicate an underactive thyroid, while a low TSH is associated with an overactive thyroid.

White Blood Cell Count (WBC)
White Blood Cell Count (WBC) The major function of white blood cells, or leukocytes, is to defend against foreign cells such as bacteria, viruses and other invaders. Low or high white blood cell counts usually indicate infection. Abnormalities are most frequently seen with infectious diseases. More rarely, a high count can be caused by leukemia.

Red Blood Count (RBC)
Red Blood Count (RBC) Red blood cells carry oxygen in the blood. Low results may suggest anemia or bleeding problems. High results may indicate too little oxygen (such as can be found in lung disease), polycythemia or dehydration. Results may vary naturally with elevation and age and may be lower during pregnancy or in young children.

Hemoglobin (Hgb)
Hemoglobin (Hgb) is the oxygen and carbon dioxide transport protein inside red blood cells. It is what gives red cells their color. Low results may suggest anemia or bleeding problems. A high result may indicate too little oxygen (such as can be found in lung disease), polycythemia or dehydration. Results may vary naturally with elevation and age and may be lower during pregnancy or in young children.

Hematocrit (Hct)
Hematocrit (Hct) is the ratio of the volume of red blood cells to the volume of whole blood. This measurement is affected by the size and number of red blood cells. Low results may suggest anemia or bleeding problems. A high result may indicate too little oxygen (such as can be found in lung disease), polycythemia or dehydration. Results may vary naturally with elevation and age and may be lower during pregnancy or in young children.

Platelets (Plt)
Platelets (Plt) are cellular particles involved in blood clotting. This test determines the number of platelets in the blood.


THE FOLLOWING TESTS ARE RED CELL INDICES

These results are calculated from measured values and are usually only considered if there are abnormal RBC counts. These tests can help your doctor diagnose different types of anemias.

Mean Corpuscular Volume (MCV)
Mean Corpuscular Volume (MCV) calculates the volume of size of the average red blood cell.

Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hemoglobin (MCH) calculates the weight of hemoglobin in the average red blood cell.

Mean Corpuscular Hemoglobin Concentration (MCHC)
Mean Corpuscular Hemoglobin Concentration (MCHC) is the amount of hemoglobin present in the average red blood cell compared to its size.


DIFFERENTIAL CELL COUNT

The differential white blood cell count is performed to determine the relative number of each type of white blood cell in the blood. There are normally five main types of cells in the blood: neutrophils (PMN’s), lymphocytes, monocytes, eosinophils and basophils. Each type of cell has a unique function in fighting disease and infection. Findings of increased or decreased numbers of individual cell types, or of immature cells can help your physician make a differential diagnosis of diseases such as bacterial and viral infections. Rarely, abnormal white blood cells may indicate other diseases, such as leukemia.

More information about most of the tests that were performed can be found at www.labtestsonline.org.

Lab Services Outside Billing
Learn more about outside billing for lab services.
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Medical Record Amendment/Correction Request
Medical Record Amendment/Correction Request
You have the right to submit a Medical Record Amendment/Correction Request for review. You will be contacted regarding the review and process after your request has been received.
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MyChart Forms
MyChart Proxy Form
Complete and bring to your doctor's office.
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MyChart Proxy Form for Minors
Complete and bring to your doctor's office.
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MyChart Brochure
More info about MyChart.
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New Patient Registration Forms
Notice of Privacy Practices
This will help expedite your check in process. Forms will also be available at each location.
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Genetic Research Authorization Form
This will help expedite your check in process. Forms will also be available at each location.
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HIPAA Acknowledgement and Consent
HIPAA Acknowledgement and Consent
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Authorization to VERBALLY Disclose Protected Healthcare Information
Authorization to VERBALLY Disclose Protected Healthcare Information
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About Us brochure
More about The Portland Clinic.
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Patient Rights
Patient Rights and Responsibilities
We want to encourage you, as a patient at The Portland Clinic, to speak openly with your healthcare team, take part in your treatment choices, and promote your own health and safety by being well-informed and involved in your care. Because we want you to think of yourself as a partner in your care, you should know your rights and responsibilities. We invite you, your family or your personal advocate to join us as active members of your care team.
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Physical Therapy Appointment Forms
Tigard Office
Print and complete the forms prior to your appointment to help reduce your check-in time:
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South Office
Print and complete the forms prior to your appointment to help reduce your check-in time:
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Downtown Office
Print and complete the forms prior to your appointment to help reduce your check-in time:
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Core Wellness Program
Print and complete the forms prior to your appointment to help reduce your check-in time:
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2015 Flu Shot Schedule
2015 Flu Shot Schedule

Beginning September 8, 2015, no appointment is necessary for a flu shot and you may go to any clinic location to have your flu shot administered.

*Pediatric and adult flu shots are available the following locations/times:

  • Downtown M-F 9-5pm (Ages 16yr and older)
  • Beaverton M-F 9-5pm (Ages 6m and older)
  • Hillsboro M-F 9-5pm (Ages 9yr and older)
  • South M-F 9-5pm (Ages 6m and older)
  • Tigard M-F 9-8pm and Sat 9-5pm (Ages 9yr and older)
  • East M-F 9-5pm (Ages 6m and older)
  • Columbia M-F 9-5pm (Ages 6m and older)

NOTE: Extra *PEDIATRIC staff will be available on the following dates for PEDIATRIC flu shots.

  • Fri, 10/9/15 @ Beaverton 9:00am-5:00pm (Ages 6m and older)
  • Weds, 10/28/15 @Tigard (9250 SW Hall, Tigard) 5:00pm-8:00pm (Ages 6m and older)
  • Sat, 11/7/15 @Tigard (9250 SW Hall, Tigard) 9:00am-1:00pm (Ages 6m and older)
  • Wed, 11/11/15 @Beaverton 9:00am-5:00pm (Ages 6m and older)

* Pediatric flu shots are offered to existing Portland Clinic pediatric patients only.

Release of Information
Transfer Information from Outside The Portland Clinic

Transferring Information to The Portland Clinic: If you are transferring your medical record information from an outside physician's office to a physician at The Portland Clinic, we ask that you complete the Release of Information form, to have your records released from their office. You will need to fax this form to the outside physician's office and they will send your information over to our office.


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Transfer Information from Inside The Portland Clinic

Transferring Information from The Portland Clinic: If you are a current Portland Clinic patient and need to have your records transferred to a non-Portland Clinic medical office, you will need to complete the Release of Information form. Please fax the completed form back to our Release of Information department at 503-620-5348.


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Sleep Assessment
More information here
This will help expedite your check in process. Forms will also be available at each location.
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Providers referring patients to The Portland Clinic
Providers referring patients to The Portland Clinic

If you are a provider and would like your patient to see one of our specialists, please complete the referral form* and fax it to our Patient Access Specialist: fax (503) 214-4690 phone (503) 802-6377. After we receive your referral, your patient will be contacted to schedule a specialist consult. If you are a patient seeking specialty care, please contact your primary care physician to refer you to The Portland Clinic. Many specialty physicians require diagnoses and chart notes before scheduling consultations.

*A complete referral contains the following:

  • · Patient demographics
  • · Patient contact information
  • · Insurance information
  • · Referral information (if insurance requires referral: approval#, date span)
  • · Diagnoses
  • · Relevant chart notes


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ICD-10 INFO
ICD-10 Coding changes in Healthcare effective October 1, 2015

Did you know that with each charge your provider submits to insurance, that he or she codes specific medical “diagnosis codes” that share more details about the health condition and reason for your visit? On October 1, 2015, the entire country switched from using “ICD-9” code set to using “ICD-10” for medical diagnosis codes. This affects any visit with a healthcare provider on or after October 1st.

The updated medical diagnosis code set, ICD-10, gets the United States in line with most industrialized countries, who moved to ICD-10 several years ago. There are many positive reasons for this change – as it enhances current medical documentation standards, allowing us to capture a greater level of detail in your health care. By coding to the ICD-10 level, providers and health care workers can provide higher quality care, with the ability to share more detail via the diagnosis codes used.

What it means for you: During this transition, it is expected that there will be challenges for both health care providers and insurance companies. The Portland Clinic expects that there could be greater delays in your medical claims being processed, as well as the potential for more pending denials from insurance companies. It does not mean that the denials or delays in processing will stop your claims from being paid, but that you may see additional EOBs (Explanation of Benefits) from your health insurance or information regarding diagnosis codes you’re not familiar with.

We encourage you to reach out to your health insurance if you have any questions on your Explanation of Benefits (EOB). Or you can also reach out to our Patient Accounts Department for questions regarding your Portland Clinic bill, Monday – Friday, 10am – 5pm at 503-221-2189.


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