Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Oregon POLST Registry before sending sensitive documents. FaxFlow is not affiliated with this organization.
Oregon POLST Registry fax number
(503) 418-2161
Oregon POLST Registry (Registry Office, supported by OHSU Center for Ethics and Oregon Health Authority)
Used for: Submitting POLST forms (front and back) to the Oregon POLST Registry via fax or mail.
Fax destination details
- Department
- Oregon POLST Registry (Registry Office, supported by OHSU Center for Ethics and Oregon Health Authority)
- Purpose
- Submitting POLST forms (front and back) to the Oregon POLST Registry via fax or mail.
- Form
- POLST form — Oregon POLST Form
- Address
- 3181 SW Sam Jackson Park Rd, Portland, OR 97239
- Voice phone
- 503-418-4083
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fax or mail POLST forms (front and back) to the Registry. Include patient’s full name, date of birth, physician/NP/PA/ND signature, date signed, and at least one completed order section. If faxing, include a cover sheet; Registry IDs may be returned on request.
Review official form instructionsSources and verification
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