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 651-738-9888 and the forms will be sent to you.
- Patient Intake Form
- Patient Registration Form
- Patient Acknowledgement Form
- Patient Service Agreement
- Consent to Treat a Minor
- Appointment Reminders
- Attendance Policy
- Telehealth Consent Form
- New Patient Insurance Information and Coverage Form
- 2022 Insurance Information Updates
- HIPAA Notice of Privacy Practices PDF
Monday-Thursday: