Legacy Salmon Creek Location
2101 NE 139th St. Suite 370
Vancouver, WA 98686
Phone: 360-892-1635
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PeaceHealth Southwest Location
505 NE 87th Ave. Suite 120
Vancouver, WA 98664
Phone: 360-892-1635
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Patient Forms

Please PRINT and fill out any requested forms and bring with you to your appointment. Thank you!

Intake and History Form

Registration Form

Records Release Form

General Medication In School Form

Camas Medication In School Form

Vancouver Medication In School Form

Sports Physical Form

ADD Parent Form

ADD Teacher Form

Well Check Policy







  • HOME
  • ABOUT US
  • PEDIATRICIANS
  • WHAT WE DO
  • ONLINE RESOURCES
  • CONTACT US