No one likes paperwork but this form provides us with your basic personal information along with your past health history and how it relates to your current condition.
We were able to eliminate the paper portion of the paperwork but you'll still need to do some work.
- Click on the button below to download the fillable PDF.
- Complete the form
- Save the completed form to your desktop computer or device.
- Email the new form to us at firstname.lastname@example.org as an attachment.
That's it. We can take it from here.
If you are unable to fill out the paperwork before coming into the office, we ask that you please arrive 15 minutes early to your appointment to fill out the paperwork.
Please email us or call us at 763-682-4000 if you have any questions.