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Patient Paperwork

The patient intake, consent to treat, and patient notice form below are to be completed by new patients.

Further down the page you will find the two release of information forms to be completed if you would like to send health records in or out of Integracare. 

All forms can be completed/submitted online, or they can be printed and brought into the office. 

This paperwork asks about your symptoms that you will be seen for during your appointment.

This consent to treat must be signed prior to receiving care at the clinics. 

This notice must be signed prior to receiving care at the clinics. This is our HIPAA paperwork.

To be completed when sending information to Integracare from another medical facility.

To be completed when sending information from Integracare to another medical facility.

integracare clinic foley

Phone: (320) 968-7234
Fax:
(320) 968-7237
Email:
info@integracareclinics.com
Clinic Hours: Monday – Friday 7am-5:30pm

Copyright 2024, Integracare LTD, All Rights Reserved. Information on this website should not be regarded as medical advice.

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