Therapy Psychiatry & Mental Health SCHRC
Patient Portal| 507-451-2630 | 1-800-722-0590

24/7 Crisis Line: 1-844-CRISIS2 or 1-844-274-7472

Outpatient Rapid Access Appointments Available Within 24-72 Hours

Forms

South Central Human Relations Center provides several forms online to save clients time when they are in the office. All forms are located below in either PDF format to print and sign (which requires Adobe Reader Icon to view the files), or online versions that can be completed and submitted electronically.

Printable Forms

Online Intake Forms

  • Adult Intake Questionnaire
  • Child and Adolescent Intake Questionnaire
  • Problem-Oriented Questionnaire for Parents – for patients of Dr. Jeanne Allen
  • Insurance and Agreements Form
  • Client Profile Form
  • Online Release of Information Forms

  • Release of Information
  • Client One-time Access