Contact Us

This Contact Form is not considered "secure" but can be used to contact our office about non-confidential topics, such as an address change or a general question about the practice. If you need to schedule an appointment, refill a medication, or need to communicate to the office about your health, please call the office directly at 503-371-3232.

Another option for current patients is to sign up for Patient Portal which will allow for secure communication with West Salem Family Practice. Call or stop by the office for more details.

Hours

Monday thru Friday: 8 a.m. - 5 p.m.

Contact

Make an Appointment

Appointments: (503) 371-3232
Fax: (503) 375-2398
Business Office: (503) 371-0145
Referrals: (503) 371-3232

Location

We are located off of Wallace Road in West Salem. If you would like customized directions just click on the map to load a Google Maps page.

Contact Form

*Required Fields

I’d like to ask a question or make a comment I’d like to request to become a new patient

Question/Comment

If you need an immediate response, please call the office directly. Sending messages via the website may take a few days to process.

I understand

Question/Comment

*Name:

*Email:

Phone:

Subject:

Comments:

New Patient Request

Due to the high number of new patient requests, I understand that I will only be contacted if I have been accepted as a new patient.

I understand

New Patient Request

*Name of the person requesting the information:

*Patient’s name:

*Address:

*City:

*State:

*Zip:

*Patient’s date of birth:

*Gender:

*Daytime phone number:

Email:

*Insurance company:

*Insurance ID number:

*Insurance policy holder name:

*Insurance policy holder date of birth:

*Who was the last primary care provider and what is the reason for the change?

*Do have any chronic medical issues that we should be aware of? If yes, what are they?

Which medications do you take daily?

*Were you referred to West Salem Family Practice? If so, by whom?

*Are you needing to be seen soon? If so, what is the reason for the visit?

Requested Provider(s):

Please note that processing time usually takes about five business days to complete and then we will contact the person making the request.

Note: If you are a current patient and are in need of immediate assistance, please call the office rather than using the contact form. Thank you.