If you are a new family and would like to register online, please fill out our online registration form.

These forms are used by Salem Pediatric Clinic for new families and are available for you to view and download. If you are unable to view the PDF forms in your browser, you should install Adobe Reader.

PLEASE NOTE BEFORE COMPLETING FILLABLE FORMS: Fillable forms require a compatible viewer, such as Adobe Reader, to work properly. You may open fillable forms, complete, and print them directly from a web browser. However, to save a completed form, you must download the PDF to your device and edit the local file using the device’s app.

We currently are NOT accepting patients that have Oregon Health Plan insurance unless the patient is a sibling of an established patient