Contact Us

REQUEST APPOINTMENT

All medical communications please use MyChart or call 541-779-5228

Note: A referral is not always needed from your primary care doctor, this form is for general questions and information only.(Fill out completely)

Use of this form constitutes your agreement to be bound by CareSubmit’s Terms of Use and Privacy Notice. Please note that your provider’s HIPAA privacy policies (contact your provider for a copy of its Notice of Privacy Practices) may also apply to information you disclose on this form. DO NOT USE THIS FORM FOR URGENT MATTERS. IF YOU ARE HAVING AN EMERGENCY, DIAL 911.