Forms

New clients:

Save time when you arrive for your appointment by completing your check-in paperwork online or by downloading, printing, and completing it at home.

Privacy Practices, Client Rights, and Data Privacy:

Review our Practices and Policies

Request your own protected health information:

Print, complete, and return this form.

Authorize someone else to access your protected health information:

Print, complete, and return this form.

Forms for Telemedicine Clients

Telemedicine clients, when requested by your provider, please print, complete, and mail to the Minneapolis clinic.

4072 County Rd 25
Minneapolis, MN 55416

Telemedicine Policy Form

Patient Health Questionnaire (PHQ-9) form

Primary Care Physician Form

Consent for Treatment Form

If you're requesting community-based services, click here.

Some of these forms are PDFs which require free Adobe Reader (or a similar software) to view. Get Adobe Reader.

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