Schedule an Appointment:
612-721-9800
About
The IHB Experience
Providers
Employment
Board
Board Member Log-in
Clinics
Counseling & Support Services
Programs
Drum Teachings for Success
Doctoral Internship Program
Dental
Medical
Telehealth
Telehealth Update Letter
How to Use Telehealth – Zoom Mobile App
Contact
Department Directory
Contact Us
Location
Resources
Calendar
FAQ
Insurance
Complaint and Grievance Report
Privacy Practices
Forms
Patient Registration Form – ENGLISH
formulario de registro del paciente
Telehealth Inform Consent Form
Telehealth Informed Consent From – Spanish
Release of Patient Information
autorización para divulgar información del paciente
PHQ Psychiatric Form
Psychiatric Meds-Ros
PHQ-A – English
PHQ-A – Spanish
PHQ9 and GAD7 – English
PHQ9 and GAD7 – Spanish
MFPP Application
Medication Assisted Treatment (MAT) Consent Form
Health Information Exchange Opt Out – English PDF
formulario de exclusion / aceptacion de intercambio electronico de informacion de salud
COVID-19
Billing Updates for COVID-19
COVID-19 Response Update April 2020
COVID-19 Response Update March 2020
Privacy Practices
Notice of Privacy Practice
Download PDF
here
.
Limited print copies available at central registration.
