New Patient Forms

The following forms need to be downloaded, read and completed prior to your initial appointment:

Informed Consent

Intake Form

Policies

Please return the completed forms to Dr. Kunkel a week before your first appointment, so he has time to review your information.  Include a check with your paperwork for your initial visit or call us at (541) 727-1893 to make a payment with your credit card.

You can provide us with the completed forms in one of three ways:

  1. You can mail these forms to:
    Curtis Kunkel, ND
    6318 SE 87th Ave
    Portland, OR 97266
  2. Or, fax them to Curtis Kunkel, ND at (541) 727-6001.
  3. Or, contact our office at (541) 727-1893  if you would like to send them via secure email and we can guide you through the process.

It is also very helpful to send Dr. Kunkel copies of all lab work that has been performed within the past 2 years prior to the initial visit.  You may need to sign a Records Release form and send it to your doctor(s) if you don’t have copies of your lab results that you can send to Dr. Kunkel.

Records Release