New Family Form

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Thank you for choosing Salem Pediatric Clinic to be your primary medical home. Please complete the below form and our office staff will contact you to complete the registration process. Please be advised that completing this form does not indicate that a physician-patient relationship has been established. We have created this form to ensure that we can help establish care for you and your family in a timely manner. If you do not hear from our office staff within seven days please call 503-362-2481.

If you are having a medical emergency please call 911 or go to the nearest emergency room.