Stem Cell Clinic & Anti-Aging Center Patient Forms

Patient Forms

Up-to-date patient information is critical for your treatment and care. Please download the appropriate patient forms, fill out and return to RestorePDX either via fax at 503-416-8732 or hand deliver prior to your appointment.

Download: Release of Information Form

Musculoskeletal and Regenerative Medicine Team: Download: New Patient Registration Form

Functional Medicine team: Download: New Patient Registration Form

Download: Referral Form