Family Medical Center | Specializing In You

PATIENT REGISTRATION

The patient registration desk is located on the street level of our Clinics in Little Falls and Pierz.

Please Note: Starting August 1st, 2009 you will be required to present your insurance card and photo i.d. at our front desk when coming in for an appointment.

Registration forms vary according to the nature of your visit.

For your convenience, you can download, print and complete any of the registration forms below prior to your visit. These forms are also available at the registration desk when you arrive. When you schedule and appointment, ask which registration forms will be needed.

Available Forms:

› Workers Comp

› HIPAA Acknowledgement

› General Patient Registration

› Health History

Little Falls, Minnesota
Family Medical Center
811 S. E. Second Street
Little Falls, Minnesota 56345-3558
320-632-2301
320-632-6611

Fax (320) 632-0534

Pierz, Minnesota
Community Medical Center
200 South First Avenue
Pierz, Minnesota 56364-0338
320-468-2536

Fax (320) 468-2728