Forms

1) HIPAA Policy

2) Notice of Privacy Practices

3) Release of Information to Pinnacle

4) Release of Information From Pinnacle

5) Financial Policy

Please fax the completed forms to (612) 437-4504, mail them to 7600 France Ave S, Suite 1100, Edina, MN 55435, or drop them off at either clinic location.

If you would like to submit these forms via the patient portal, please call the clinic so we can securely place the forms in your portal. If you have any questions about how to submit the forms, feel free to contact our office.