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Patient Portal

Patient Forms

Patient Registration Forms

  • Acknowledgment of Receipt of Notice of Privacy Practices
  • Advanced Directive Acknowledgement
  • Authorization to Furnish Information / Assignment of Benefits
  • Notice of Privacy Practices
  • Patient Registration Update Form
  • Patient Rights and Responsibilities
  • Privacy Act of 1974 – Statement of Maintenance of Health Records
  • Registration Instructions
  • Complete Patient Registration Packet

Other Forms

  • Authorization for Use or Disclosure of PHI – Behavioral Health Records
  • Authorization for Use or Disclosure of PHI – Patient Health Records
  • KTHFS Employee-sponsored Emergency Assistance Fund Application
  • Patient Complaint Form
  • Compliance Hotline
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Administration

3949 S 6th Street
Klamath Falls, OR 97603
(541) 882-1487

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Wellness Center

330 Chiloquin Boulevard
Chiloquin, OR 97624
(541) 882-1487

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Youth & Family Guidance Center

635 Main Street
Klamath Falls, OR 97601
(541) 884-1841

Useful Links

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The Klamath Tribes

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Indian Health Services

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Northwest Portland Area Indian Health Board

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National Indian Health Board

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Patient Portal

Patient Services

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Behavioral Health

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Purchased & Referred Care

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Health Education

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Special Programs

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Transportation

Hours

MON - FRI

7:30am - 5:00pm

SAT -SUN

Closed

Appointment
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Address

Rock St 12, Newyork City, USA
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Phone

(01) 234 5678 98
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Time

Week Days: 09.00 to 18.00 Sunday: Closed