Patient Paperwork

New to Nehalem Bay Health Center? Welcome!

New Patient Paperwork - to save time, you can download the new patient paperwork, fill it out ahead of time online, print it, and bring it in with you for your appointment.

Sliding Fee Scale available:  Nehalem Bay Health Center provides care, on a sliding scale, regardless of the ability to pay. For more information on how to apply, please ask at the front desk. You can download the sliding fee guidelines and application by following the links below. 

Sliding Fee Scale paperwork:

MyChart - Access your health record online

Have you signed up for MyChart yet? Learn more here: Nehalem Bay Health Center MyChart

Medical Records Release Forms:

The Medical Records Release Forms can be turned in at the front desk, mailed (to PO Box 176, Wheeler, OR 97147 to the attention of Medical Records), or faxed to 844‐712‐3001. Depending on the type of request, we typically have up to 30 days to respond (but we do our best to get them out sooner). Patients who want to see their records can also sign up for MyChart.

Your feedback is important to us:

If you had an unsatisfactory experience at Nehalem Bay Health Center or Nehalem Bay Pharmacy, we would like to hear about it.

Appointment Day Checklist:

  • Please arrive 15 minutes early if your paperwork is filled out in advance;

  • Please arrive 30 minutes early to fill out paperwork (if you don’t have a chance to fill it out in advance);

  • If you are on any medications, please bring your medications with you (in the bottle);

  • Bring your health insurance card (if you have insurance);

  • Please bring a picture ID with you.

How are we doing?

Do the services we provide meet your needs? Is there anything we might need to improve?

Please take our Patient Satisfaction Survey:

The survey should take you about 5 minutes to complete and is completely anonymous.

A Note about Pain Management:

Nehalem Bay Health Center & Pharmacy is here to serve all your health care needs, including helping our patients manage their chronic pain when needed. It should be noted, however, that pain management is not our primary focus. Rather, pain management is part of the comprehensive, integrated approach we use with all our patients, working together with the patient and our entire team for the best outcomes.

Here are some things you need to know if you want to establish care for pain management at Nehalem Bay Health Center:

  • These services are available only for Nehalem Bay Health Center patients. If you wish to be seen for help managing pain, you will need to establish care with one of our primary care providers.

  • If pain management is needed, there is a review process that will need to be completed before we decide whether prescription opioids are an option for you. This process can take up to six weeks to complete, and can include (but is not limited to):

    • Obtaining full records of the pain problems and diagnoses to date;

    • Getting a full behavioral health history by one of our specialists; and

    • Getting an oral swab and/or urine analysis to check for drugs and alcohol.

  • Once the screening and review process are complete, the case will be presented to a multi-disciplinary team at Nehalem Bay Health Center, and a decision will be made about whether we will be able to provide chronic pain management.