(541) 677-6116 Fax: (541) 957-5181
2589 NW Edenbower Blvd., Roseburg, OR 97471 | Office Hours

Forms & Policies

School/sports/daycare/camp forms will be completed free of charge at the time of a well visit. Please complete all of the parental sections of forms prior to presenting to our staff. Forms can be completed at other times for a $10 fee with a turn around time of approximately 3 business days. There is a $30 fee for "rush" same-day completion forms that are not presented at the time of a well visit.

Please complete patient and parent information on forms prior to handing to our staff. We process large numbers of forms and want to make sure the information is appropriately entered. Many times outside entities will accept our standard school/camp form which can be printed and provided free of charge at your child's well visit. Ask us to print a form during your visit so that you can have it on hand in anticipation of future needs.

School/sports/daycare/camp forms will be completed free of charge at the time of a well visit. Please complete all of the parental sections of forms prior to presenting to our staff. Forms can be completed at other times for a $10 fee with a turn around time of approximately 3 business days. There is a $30 fee for "rush" same-day completion forms that are not presented at the time of a well visit.

Please complete patient and parent information on forms prior to handing to our staff. We process large numbers of forms and want to make sure the information is appropriately entered. Many times outside entities will accept our standard school/camp form which can be printed and provided free of charge at your child's well visit. Ask us to print a form during your visit so that you can have it on hand in anticipation of future needs.

Forms & Policies

General Forms

Is Your Child Sick?®

Visual Symptom Checker What's Going Around?
scout

North River Pediatrics
2589 NW Edenbower Blvd. | Roseburg, OR 97471 |
(541) 677-6116 | Fax: (541) 957-5181 | DIRECTIONS