*NOTICE: THE PAPERWORK OPTION IS LIMITED TO ELECTRONIC SUBMISSION DUE TO
PROVIDING TELEHEALTH DURING THE COVID 19 STATE OF EMERGENCY.
PLEASE CALL (218) 699-3510 FOR ASSISTANCE.
Paperwork will need to be filled out prior to your first appointment. Please click on the links below to fill out your paperwork electronically. If you need technical assistance, please call (218) 699-3510.
Note: To download Adobe Acrobat Reader for free, click here.
Mental Health & Chemical Health Intake Forms
Current Patients
Please fill out one of the following prior to your next appointment:
Current Patient Service Application: current-patient-application.pdf
New Patients
Please fill out one of the following prior to your 1st appointment:
Child Service Application: 06-20-2020-child-service-application.pdf
Adult Service Application: 10-20-2020-adult-service-application.pdf
For Coordination of Care:
(with outside providers, friends, family members, etc.)
Release of Information: sanford-health-release-form.pdf