To schedule an appointment, please contact our office directly at 503.635.4886 or use this form below. For more information about our services, or any other questions or comments, please complete the form below.

The Petroff Center
17720 Jean Way
Suite 100
Lake Oswego, OR 97035
Tel: 503.635.4886
Fax: 503.635.1655

Office Hours
Monday, 9 a.m. - 5 p.m.
Tuesday-Friday, 8:30 a.m. - 5 p.m.

Note: Do NOT use this form for an emergency!

* Name:
Address:
Suite:
City:
State:
Zip:
Country:		United States Canada Mexico United Kingdom Ireland France Italy Denmark Russia Brussels Netherlands Greece Turkey Israel Monaco Switzerland Sweden Germany Japan Singapore China - Hong Kong Korea Malaysia Brazil Colombia Caribbean Peru Argentina Other
Phone:
Fax:
* E-Mail:
Would you like to schedule an appointment?		Yes No
Please provide us with information about when you would like an appointment.
Month of  Time Day -choose- January February March April May June July August September October November December Morning Afternoon -choose- Monday Tuesday Wednesday Thursday Friday
How did you hear about our practice:		Referral from friend/co-worker Physician Advice Web Search Facebook LinkedIn Myspace Twitter PortlandPicks YouTube Google Other
Questions/Comments:
		Please enter in the characters shown below. Having a hard time reading? Move your mouse over the speaker...

Please be aware that this is a non-secure communication.

back to top