Prepare For Your Visit – Fall Creek Internal Medicine

Welcome to Fall Creek Internal Medicine

Important Reminders before your first appointment

Please arrive 15 minutes early for your appointment
Please bring your completed New Patient Paperwork, Insurance Card and Photo Identification
Please do not wear perfume, cologne or any fragrances to your appointment

If you do not arrive 15 minutes prior to your scheduled appointment time, we may have to reschedule your appointment.

If you need directions to our clinic, please refer to our contact page, or call us at 541-389-1118

Thank you and we look forward to meeting you.

Directions to Fall Creek Internal Medicine
2160 NE Williamson Ct
Bend, OR 97701

We are off NE Neff Rd which runs in between St Charles Health System (the hospital) and Summit Medical Group (formerly Bend Memorial Clinic). Turn onto NE Williamson Blvd (COPA is a landmark on the corner of NE Neff/NE Williamson Blvd) follow that down 2 blocks and turn right onto NE Williamson Ct. We are the first Driveway on the right.

New Patient Registration Forms

FCIM PT REGISTRATION FCIM HIPAA FORM FCIM OFFICE AND FINANCIAL POLICIES FCIM PT MED HISTORY - MED LIST ACKNOWLEDGEMENT OF PRIVACY PRACTICES POLICY OFFERED, REFERRAL RIGHTS FCIM PATIENT PORTAL POLICY REQUEST FOR MEDICAL RECORDS

Important Patient Notifications

FCIM NOTICE OF PRIVAY PRACTICES 7.19.2024 PERSONAL RELEASE OF MED RECS 2023 Medicare Portal_Beneficiary Notice 2023_English_1432-22_F 2023 Medicare Portal_Beneficiary Notice 2023_Spanish_F

Commercial Insurance Annual Preventative Visit Forms

ROS 2024

Medicare Advantage Forms

MEDICARE ADVANTAGE PATIENT HEALTH QUESTIONNAIRE MEDICARE ADVANTAGE REVIEW OF SYSTEMS AND SOCIAL HISTORY

Medicare Annual Wellness Visit Patient Forms

MEDICARE REVIEW OF SYSTEMS AND SOCIAL HISTORY MEDICARE ADVANCE BENEFICIARY NOTICE OF NONCOVERAGE (ABN)