Patient Paperwork

In Portland, OR

Home » Patient Resources » Patient Paperwork

First Name(Required)

Last Name(Required)

Phone(Required)

Email(Required)

Procedure of Interest(Required)

Message(Required)

Contact List(Required)

Yes! Please send me info on events and specials!

Consent(Required)

Checking this box is my signature to agree to receive text messages about my healthcare and for marketing purposes, including autodialed, from Key Laser Institute. I understand that this consent is not a condition of purchasing any goods or services, I can opt-out at any time, message/data rates may apply per my phone plan, and opting-in includes acceptance of our Privacy Policy and Terms of Service

Patient Paperwork

If you have never been to Key Laser Institute or haven’t been within the last year, please print out and bring our new patient paperwork:

New Patient Form 2020

To review our policy for virtual consultations please click on the link below:

Virtual Consultation Consent Form

To review our policies and risks regarding COVID-19, please click on the link below:

COVID-19 Risk Informed Consent Form