Program Application

To make your consultation with our staff more effective and efficient, it helps to have some information about you before your initial visit. Please click the link below, print the document, fill it out, and be sure to bring it with you to the informational seminar or return it to our office.

You may fax or mail it to:

PeaceHealth Medical Group Surgery
RiverBend Pavilion, 2nd floor
3377 RiverBend Drive
Springfield, OR 97477

Fax: 541-222-6113

Download the program application