Minnesota Mental Health Clinics
Online New Client Intake Forms
Therapy Online Intake Forms
Click the link above to fill out the new client therapy forms before your appointment. Include assessments, disclosures, and release forms.
ASTAT Online Intake Forms
Click the link above to fill out the new ASTAT client forms before your appointment. Include assessments, disclosures, and release forms.
Psychiatry - Under 18 Online Intake Forms
Click the link above to fill out the intake forms for psychiatry patients under age 18 before your appointment. Include assessments, disclosures, and release forms.
Psychiatry Age 18 & Older Online Intake Forms
Click the link above to fill out the intake forms for new psychiatry patients age 18 and over before your appointment. Include assessments, disclosures, and release forms.
Case Management Online Intake Forms
Click the link above to fill out the intake form for new Case Management patients.
Other Online Client Forms
- Intake Information
- HIPAA 2022 Update Form
- Clients Rights & Responsibilities
- Treatment Agreement
- Consent for Service
- Fee Policies and Authorization of Benefits Agreement
- Consent for Telehealth Services
- Referral for Psychiatry Services
- Psychiatry Safety Plan for After Hours Care
- Optum Supervision Form
- Supervision Form - All other payers
- Current Client Yearly Update Packet
- Release for Intern/Student or Non-credentialed Licensed Provider to Observe Treatment
Online Release of Information Forms
- Release of Information - General Form
- Release of Information - Emergency Contact
- Release of Information - Primary Care Provider
- Release of Information - Behavioral Health Provider
- Pharmacy Release of Information
- Release for Intern/Student or Non-credentialed Licensed Provider To Observe Treatment
- Medicare Release Authorization
Online Health & Wellness Questionnaires (Screening Tools)
Optum Adult Wellness Form
For the Optum Adult Wellness form, please click above to access a PDF of the form. You can fill it out on your computer and print it out, or print the form and then fill it out. Once you've completed the form, please fax it to our office at 651-454-3492 or drop it off at one of our clinic locations.
Optum Youth Wellness Form
For the Optum Youth Wellness form, please click above to access a PDF of the form. You can fill it out on your computer and print it out, or print the form and then fill it out. Once you've completed the form, please fax it to our office at 651-454-3492 or drop it off at one of our clinic locations.
Brochures & Documents
ADHD Brochure
Adult ADHD Treatment Program
ASTAT Brochure
Adolescent Short-Term Assessment and Treatment Program
DaTRAC / STAT Brochure
Adult Day Treatment Program / Short-Term Assessment and Treatment Program
MMHC Crisis Phone Numbers
Should you need to talk to someone right away, the following crisis lines are available 24 hours, seven days a week.
Online New Client Intake Forms
Therapy Online Intake Forms
Click the link above to fill out the new client therapy forms before your appointment. Include assessments, disclosures, and release forms.
ASTAT Online Intake Forms
Click the link above to fill out the new ASTAT client forms before your appointment. Include assessments, disclosures, and release forms.
Psychiatry Age 18 & Older Online Intake Forms
Click the link above to fill out the intake forms for new psychiatry patients age 18 and over before your appointment. Include assessments, disclosures, and release forms.
Therapy Online Intake Forms
Click the link above to fill out the intake form for new Case Management patients.
Other Online Client Forms
- Intake Information
- HIPAA 2022 Update Form
- Clients Rights & Responsibilities
- Treatment Agreement
- Consent for Service
- Fee Policies and Authorization of Benefits Agreement
- Consent for Telehealth Services
- Referral for Psychiatry Services
- Psychiatry Safety Plan for After Hours Care
- Optum Supervision Form
- Supervision Form - All other payers
- Current Client Yearly Update Packet
- Release for Intern/Student or Non-credentialed Licensed Provider to Observe Treatment
Online Release of Information Forms
- Release of Information - General Form
- Release of Information - Emergency Contact
- Release of Information - Primary Care Provider
- Release of Information - Behavioral Health Provider
- Pharmacy Release of Information
- Release for Intern/Student or Non-credentialed Licensed Provider To Observe Treatment
- Medicare Release Authorization
Online Health & Wellness Questionnaires (Screening Tools)
- Adolescent SDQ Questionnaire
- Parent SDQ Questionnaire
- PHQ-9
- Cage-Aid Questionnaire
- BAI: Beck Anxiety Inventory
- WHODAS 2.0
- Review of Systems
Optum Adult Wellness Form
For the Optum Adult Wellness form, please click above to access a PDF of the form. You can fill it out on your computer and print it out, or print the form and then fill it out. Once you've completed the form, please fax it to our office at 651-454-3492 or drop it off at one of our clinic locations.
Optum Youth Wellness Form
For the Optum Youth Wellness form, please click above to access a PDF of the form. You can fill it out on your computer and print it out, or print the form and then fill it out. Once you've completed the form, please fax it to our office at 651-454-3492 or drop it off at one of our clinic locations.
Brochures & Documents
ADHD Brochure
Adult ADHD Treatment Program
ASTAT Brochure
Adolescent Short-Term Assessment and Treatment Program
DaTRAC / STAT Brochure
Adult Day Treatment Program / Short-Term Assessment and Treatment Program
MMHC Crisis Phone Numbers
Should you need to talk to someone right away, the following crisis lines are available 24 hours, seven days a week.