Patient Forms

New patients may pre-register by printing and completing the following forms:
Pre-Registration Form (pdf)
Notice of Patient Privacy Practices (pdf)
 

Consent for Minors

Written consent is required when someone other than the parent/guardian will accompany a minor patient to their appointment. If it is anticipated that the parent/guardian will not be present for the appointment, the Consent for Minors Medical Care and Information should be completed by the parent/guardian and be brought to the appointment.

Medical Records

Your medical records are the property of the UND Center for Family Medicine. Information in your medical chart is confidential and the content of your medical record is released only with your hand-written consent. No information is released without your signed authorization.
Release of Patient Medical Information (pdf)