Text Size: A+| A-| A   |   Text Only Site   |   Accessibility
Hospital Reporting
Submit a Report
Report Form
Click "Hospital Report Form" to the right to access the adverse event reporting form for Oregon hospitals.  Choose the correct harm level to display all required fields.
 
Note: File may take a few seconds to load.

Guide to Reporting Adverse Events for Oregon Hospitals
An instructional guide for reporting adverse events is available here

Report Form

Hospital Report Form
 
Page updated: April 07, 2009

Click here to go to the Oregon Dept. of Veterans' Affairs outreach contact form

Get Adobe Acrobat ReaderAdobe Reader is required to view PDF files. Click the "Get Adobe Reader" image to get a free download of the reader from Adobe.