Because we are a specialty center, managed care insurance plans usually require a referral and/or pre-authorization from a primary care physician. The exception is that no referral is required for an annual examination or early pregnancy follow up.
If you would like to refer your patient to The Fertility Center of Oregon please print out the referral form and either fax it to us @ 541-683-1709 or scan and email to [email protected]
Note: These are fillable forms that were designed to work with Adobe Acrobat Reader (version 7.0 and above). You’ll need to click on the link to download them, save them to your computer, then open them inside of your Adobe Acrobat Reader program. If you have any issues downloading and filling them out, please click on this link to troubleshoot.
Authorization to disclose information to FCO from another facilityAuthorization to disclose information from FCO to another facility