Patient Registration, Information & Forms

Once an initial evaluation has been scheduled with FAC, please complete all of the secure forms listed below. Please allow yourself 30 minutes to complete the forms. If you prefer that the forms be mailed to you, contact us at 651-738-9333 and the forms will be sent to you.

• Patient Intake Form CLICK HERE

• Patient Registration Form CLICK HERE

• Patient Acknowledgement Form CLICK HERE

• Patient Service Agreement CLICK HERE

• Consent to Treat a Minor CLICK HERE

• Appointment Reminders CLICK HERE

• Attendance Policy CLICK HERE

• Telehealth Consent Form CLICK HERE

• Insurance Information and Coverage Form CLICK HERE

• HIPAA Notice of Privacy Practices CLICK HERE
 

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