Resources/Forms

Forms

Health History Questionnaire (for women younger than 45 who are not experiencing perimenopausal or hormonal deficiency symptoms). Completing this form helps Anne Marie quickly review your medical history and symptoms with you.

Menopause Health History Questionnaire (for women younger 45 and other or who are experiencing menopausal or hormonal deficiency symptoms). Completing this form helps Anne Marie quickly review your medical history and symptoms with you. This more comprehensive questions has more detailed questions for evaluation of menopause and hormone concerns.

Release Form for requesting your records for Anne Marie from a previous provider.

Partners in Your Care

Balance, Beauty, and Health — Dana LaVoie, LAc, MAcOM, provides accupuncture and herbal consultation from her Eugene office. Aesthetician Celine Bailey rounds out the balance of beauty and health provided by this recommended clinic.

Broadway Apothecary Compounding Pharmacy — If you will require compounded prescription medicines (ones prepared specifically to your requirements), Anne Marie may recommend our local compounding Pharmacy at 15th and Oak St in Eugene.

PeaceHealth Laboratories — Find PeaceHealth Lab locations here. With lots of locations, PeaceHealth may have a location closer to your home or office. If so, Anne Marie can place your order with the lab that’s most convenient to you.

Oregon Imaging Centers — Needing a mammogram? Other imaging? Once Anne Marie has recommended screening or diagnostic imaging, you can schedule with the Oregon Imaging Centers location for your procedure.

Golden Apple Healthcare – Bill Walter, ND provides naturopathic healthcare services in a similar patient-focused practice at the Chiropractic Healing Center in Eugene.

Products

MiddlesexMD — Enjoy sexuality for life! Advice and products that can help.