To Request to Become a New Patient - Fill Out the Form Below

This form is for new patient inquiries only. We are located at 1426 Oak Street, Eugene, OR 97401.


If you are an existing patient please call us at (541) 431-0000 for questions.


We look forward to hearing from you!

-Oak Street Medical

 
 
 

Example: 971-612-6100

 
 

Example: 01/01/1985

 
 
 
 

Please indicate the name of your insurance Examples: Pacific Source, United Health Care (UHC), Providence, Atrio, PEBB