Required forms
You must complete some forms before you can receive services at a Minneapolis School Based Clinic. Get them online or at the clinic.
View and download general forms
You can download forms in many languages. We tell you how often you need to submit each form and who needs to sign it.
English, Somali, Spanish
Submit once
Parent or guardian and students age 18 and older must sign
View and download forms for certain services
You can download forms in many languages. We tell you how often you need to submit each form and who needs to sign it.
English, Hmong, Somali, Spanish
Good for three years
Student and parent or guardian signature
English, Somali, Spanish
Submit once
Student and parent or guardian signature
English, Somali, Spanish
Submit every time you get a vaccine
Student and parent or guardian signature
Clinic policies
Read about our policies, your rights and more.
Contact us
Phone
Address
Public Service Building
505 Fourth Ave. S., Room 520
Minneapolis, MN 55415