Liberty Neuro Specialists
Please print, fill out, and bring these forms to your appointment. This will facilitate your check-in process with our office. If you have any questions please call the office at 503-581-5517. Thank you.
If you are to see Dr. Collada please fill out the following forms
If you would like to release your records to either yourself or another entity/clinic please use the following form and return the form to our office. Please note that all chart notes will automatically be sent to your referring and primary care doctor.
Mail request to: 1344 Liberty ST SE, Salem, OR 97302
or send us an email request through the patient portal
or Fax: 503-581-6341
If you are to see Dr. Coon please fill out the following forms
Please print or save for your records