These forms are for the convenience of new clients. Please complete all forms prior to your visit to allow for maximum face-to-face time during your initial visit.  Pediatric patients do not fill out the Health History Questionnaire, only the Pediatric Intake Form.  Current clients with a change in address or insurance: please complete a new Patient Information form with your updated information.


  • (Please note, this policy has changed as of 03/01/2019) There is a 48 hour cancellation policy for all patients, new and established. Please give 48 hours notice in the case of cancellation or rescheduling your visit, or there is a $100 fee. Please call the office within an hour of your appointment for possible exceptions to this policy. If a patient needs to cancel or reschedule a New Patient visit, the office assistant will call to collect a credit card number as we charge the full fee for a New Patient visit ($250) if this policy is breached a second time.

  • The Gotham building has several entrances. The easiest way to find Suite 176 is to enter in the door marked 2256 N. Albina on the corner of North Interstate and Albina Aves. There is a Docere Naturopathic Wellness sign hanging over this entrance. Walk all the way down the hallway and the office door is the last on the left. If the door is closed, she's with another client and please have a seat in the waiting area.

  • Dr. Sam does not administer immunizations at this time. There are several clinics in town including travel clinics and ZoomCare that can give the vaccines you are choosing.

  • Dr. Sam can have any supplement refills for established patients drop-shipped to your home with advanced notice. Shipping is usually $6 for most orders. Please email or call in this request. Also, you can order directly from Dr. Sam’s distributor via the link on the homepage to the online medicinary.

  • Feel free to call the office staff or email with any questions or concerns!