Forms
First Visit
Please read and fill out the following forms before you come in for your first visit:
1. New Patient Registration
2. Insurance Card
3. Health History
4. Dear Patient
5. Medication Reminders
6. Notice of Privacy Practices
7. Authorization for Release of Protected Health Information
8. Patient Authorization for Proxy
9. Headache Assessment (Optional)
Minneapolis Office
Medical Arts Building
825 Nicollet Mall, Suite 1149
Minneapolis, MN 55402
Phone: 612-338-3333
Fax: 612-349-3838
St. Louis Park Office
Ear, Nose, & Throat Specialty Care
Xchange Medical Building
6099 Wayzata Blvd, St. Louis Park, MN 55416
Phone: 612-338-3333
Hours
Monday - Friday
8:00 AM - 5:00 PM
