Becoming a Patient

Welcome, new patients! We look forward to providing you with excellent healthcare and support on your wellness journey.

Our mission at Coquille Valley Hospital is to improve the lives of the people in the communities we serve by providing excellent, high-value healthcare services, delivered with professional competence and compassion. We are honored that you have entrusted us with your healthcare needs.

Please review and complete the following forms before your appointment. Thank you!

Patient Registration Form