Columbia Park Medical Group

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Patient Forms

The forms and brochures below are provided online as a service to our patients. The registration form may be filled out prior to your visit, and brought with you when you come in. Please note it is not an option to e-mail the form to our clinics. The forms are also available at each of our clinics and may be completed at the time of your visit. The brochures are also available at each clinic.

All of our online patient forms and brochures are in PDF format, and must be opened with Adobe Acrobat Reader. If you don't have Adobe Reader installed on your computer, you may download a free copy by clicking the "Get Adobe Reader" link below. After installing the program you can proceed by clicking the form/brochure that you'd like to open. The selected form/brochure will open in your browser window; after printing the form/brochure you can return to this page by clicking your browser's back button.

For your convenience, there are two versions of each registration form:

The Fillable Forms can be filled in on your home computer. You can move around the form by using your mouse or the <tab> key, and your information can be typed in. The completed form can then be printed using your home printer.

The Printable Forms can only be printed. The form can then be completed by handwriting your information. All brochures are in printable format only.

 

 

Fillable Forms:

(F) Patient Registration and Consent Form

Printable Forms:

(P) Patient Registration and Consent Form

(P) Authorization for Release of Health Information Form

Printable Brochures:

Clinic Location Guide

 

History | Services | Physicians | Business Services
Employment | Physician Recruitment | Online Appointments | Patient Forms

Andover | Blaine | Brooklyn Park | Columbia Heights | Fridley | Imaging Center

Our Clinics

Andover Park Clinic

Brooklyn Park Clinic

Columbia Park Clinic

Fridley Plaza Clinic

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