OAG – Compliance Department
707 SW Washington St., Suite 700
Portland, OR 97205
Attention: Compliance Department
Call us: 503-299-9906
Note: OAG maintains patient billing records for both OAG and OAG Interventional Pain Consultant (IPC) patients.
Request Billing Records for Yourself or Your Family
To have records sent to yourself or to another person or a company, send us a letter with your request.
Please make sure your letter includes the following:
Patient’s full name
Patient’s date of birth
Date(s) of service or date range of the billing records you're requesting
Name, signature, and date of person requesting billing records
Relationship to the patient (e.g., self, parent, personal representative)
Note: If you are a personal representative signing the letter on behalf of the patient, please provide a description of your authority to act on behalf of the patient and a copy of official documentation granting this authority.
Indicate how you would like to receive the records:
If by mail, please include the delivery address; or,
If by fax, please include the fax number; or,
If by secure e-mail, please clearly write the email address.
Phone number in case we have questions
This service is free of charge.
For third-party requests
Please download the Information Authorization Form and ask the patient to sign the completed form.
Note: OAG charges a flat fee of $30 to process requests from third parties.
Requesting Medical Records
Request Anesthesia Medical Records
Your anesthesia medical records can be requested through the facility where you received medical services.
Request Interventional Pain Clinic (IPC) Medical Records
Your (IPC) medical records can be requested from SIS NW, Inc.
They will need the Information Authorization Form signed by the patient.
Contact them at 206-686-2821 or email@example.com or fax 206-686-2840.