full screen background image
Please feel free to read and or print these forms

New Patient Forms Packet-07/2017
Established Patient Forms Packet-07/2017
Patient Acknowledgement & Consent for Health Information Disclosure, Evaluation, Treatment, and Billing
Patient Approved List of Contacts
Patient Authorization for Electronic Health Records (Umpua One Chart)(Updated 09/2013)
Patient Financial Assistance Application
Patient Financial Assistance Policy
Dietary Supplements List Form
Patient History Questionnaire-07/2017
Patient Self-Assessment Form
Symptom Assessment Form
Patient Notice of Privacy Practices-05/2017
Patient Satisfaction Survey
Colorectal Awareness Facts
Program Volunteer Tracking Sheet
2015 FOH 10k & 5k Results
2016 FOH 5k Results
2017 FOH 5k Results
2018 FOH 5k Results
FredMeyer Community Rewards
FRESHSTART® Tobacco Cessation 4-Week Course
2019 Focus on Hope Vendor Info
Focus On Hope 2019 Registration
Focus On Hope 2019 Flyer_Final
Picnic in the Park 2019 Flyer
DEEP | Diabetes Class Flyer (UHA)
SOLE Survive-N-Thrive (Walking Groups)
Tobacco Cessation Flyer 2019_04
Cancer Support Group 2019
War on Melanoma™ Flyer
FRESHSTART® Summer Tobacco Cessation 4-Week Course
Skin Cancer Screening Clinic Flyer
Living Well Programs 2019-2020
 Admin Login
© Copyright 2019 Community Cancer Center. All Rights Reserved.