We are happy you have chosen North Clinic for your healthcare needs.
Health History Questionnaire for New Patients
To better serve you and help save time when you arrive for your first appointment, you may download, print and complete our Health History Questionnaire prior to your visit. If you're unable to complete this form ahead of time, we ask that you arrive a few minutes ahead of your scheduled appointment time to complete the form in the office. We ask that you bring the completed form and your current insurance card to your appointment.
If you have questions, please call our Business Office at (763) 587-7811.
Thank you in advance for completing this form. We are looking forward to meeting you and providing for all your healthcare needs.
Authorization for Release of Information Form
If you need the release of your medical information, please print and complete our Authorization for Release of Information Form. You may deliver the completed form to the facility from which you are requesting your medical information.
If you have questions, please call Medical Records at (763) 587-7943.