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Want to be a member?

01.

Is NICC's DPC for you? Come talk to us or reach out with your questions!

02.

Follow the link below to fill out your medical history and demographic information. If you would prefer to fill out a hard copy please email NICC's at:

admin@niccdpc.com 

03.

We will schedule a visit for you to meet your provider.

We do this to ensure that we are a good fit for you and your family, to answer questions, and learn about your health goals. 

04.

After ensuring that we are a good fit for you and that we will be able to help you meet your health goals, we will charge the enrollment fee and set up your payment plan and you will have access to all the membership benefits.

Membership Application 

Please follow the link below to fill out membership application. Your information will go directly into our secure Electronic Medical Record System to be reviewed by our providers.

Retainer Medical Agreement 

This agreement outlines what you can expect from our office and what we expect from you. We will have you sign a copy at your first appointment with us. 

PDF

Office Phone:  541-238-6432     4509 S 6th Street, Suite 301, Klamath Falls OR  97603

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