Empowering minds, nurturing lives;

your path to understanding, healing and thriving

Patient Forms

PsychNW is committed to equal care for all our patients. Our Patient Non-Discrimination Policy was
established to protect the well-being of every patient under our care.
It is the policy of PsychNW to provide equitable care without discrimination against, or harassment of, any
person on the basis of race, color, national origin, language, religion, sex, age, disability, citizenship,
marital status, creed, sexual orientation, gender expression or gender identity (the patient’s preferred
gender will be respected, and the patient will be referred to by their name and pronoun of choice,
whenever feasible) or other non-medically relevant factor or any other characteristic protected by federal
or state law. Any such discrimination or harassment is prohibited and will not be tolerated.
PsychNW prohibits workplace discrimination, harassment, or retaliation on the basis of gender identity or
gender expression. Discrimination, harassment, and retaliation are prohibited in the workplace, and/or in
any work-related setting outside the workplace. Employees who violate this rule may be subject to
disciplinary action, up to and including termination. Every employee shares the responsibility for promptly
bringing to the attention of PsychNW any conduct that interferes with providing a work environment free of
discrimination, harassment, and retaliation on the basis of gender identity or gender expression

email: psychnw@psychnw.com
P.O. Box 671 Donald, OR 97020

Phone: 503-877-0711
Fax: 503-914-0315