Thank you for scheduling a free youth heart screening through our Play Smart program.

Below are 2 items needed for your appointment. Please take a moment to review.

PRIOR TO APPOINTMENT ARRIVAL
Intake Information Form - This is a digital form to complete and submit as soon as possible following your appointment scheduling. Our staff will use this information to prepare for your screening.

WHEN YOU ARRIVE TO APPOINTMENT
Consent Form - You will complete this form at check-in for your appointment. We are unable to conduct the screening without this important information. Please note the following:

  • Oregon Resident: If you are under age 15, a parent/guardian must be present to sign the consent form.

  • Residents of all other states: If you are under age 18, a parent/guardian must be present to sign the consent form.

IMPORTANT COVID INFORMATION
Please limit who attends with you to only one necessary individual. Mandatory face masks are required. We ask that you reschedule your appointment for a future screening if you have any of the following symptoms or scenarios:

- If you have any COVID-19 symptoms such as fever, cough, or shortness of breath
- If you have been exposed to someone who has COVID-19 or is showing symptoms of COVID-19.

Thank you for your cooperation.

Questions? We are happy to help. Please call 503-216-0880 or email.