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503 874 0574

Falls Canyon Surgical Associates

Falls Canyon Surgical Associates

  • About
    • Liska L. Havel, MD, MPH
    • James P. Nealon, MD, FACS
  • Services
  • For Patients
    • Billing
    • Patient Forms
    • Preparing for Surgery
    • Preparing for Colonoscopy
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Patient Forms

📝 Patient Forms

To help us assist you prepare for your visit or assist you with your needs, please complete the relevant forms ahead of your appointment. You can download and print the forms below:


📂 General Forms

  • Patient Allergy List (English)
  • Patient Allergy List (Spanish)

🌐 Patient Demographics

  • Patient Demographics Form (English)
  • Patient Demographics Form (Spanish)

🩺 Health History Questionnaire

  • Patient Health Questionnaire (English)
  • Patient Health Questionnaire (Spanish)

🧭 Hospital Campus Maps

  • Silverton Hospital Campus Map (English)
  • Silverton Hospital Campus Map (Spanish)
  • Stayton Hospital Campus Map (English)

If you have any questions about which forms to fill out, how to return them, or if your forms are missing from this list, please call our office at 503-874-0574. We’re happy to help!

Copyright © 2025 Falls Canyon Surgical Associates