Thank you for your interest in Oregon Occupational Medicine. Please complete the pertinent sections in this form. If you have any questions please contact us at 503-563-5382. We look forward to providing excellent occupational medicine services to your company.


ATTN Patients: If you are currently experiencing any of the following symptoms; cough, runny nose, body aches, or fever, we respectfully ask that you CALL our office to reschedule your appointment in two weeks from now. 

Learn more about what OOM is doing about COVID-19 here

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