Family Life Mental Health Center

	Specialists In Mental Health Services

Getting Started
To become a client at Family Life Center, you must first complete our intake paperwork which can either be filled out at Family Life Center, picked up and filled out at home, or printed from this website and returned to Family Life Center.

When submitting paperwork, you must also submit a copy of either a drivers license or MN ID and a copy of your insurance card.

When the paperwork has been completed and submitted, our Business office and Intake Specialist will review the information. They will verify insurance coverage and select the provider that would best meet your needs. You will be contacted within three to five business days to schedule your first appointment.

Paperwork hours are Monday through Thursday from 9:00 am to 7:00 pm and Friday from 9:00 am to 4:00 pm. No appointment is necessary to complete paperwork.

Print Paperwork here: Microsoft Word Format

Paperwork for Adult Applicants

Family Life Center Policies

Family Life Center Privacy Policy (HIPAA)

Adult Intake Application

Signature Sheet

Release of Information

Paperwork for Child or Adolescent Applicants(under 18 years old) to be filled out by a Parent or Legal Guardian:

Family Life Center Policies

Family Life Center Privacy Policy (HIPAA)

Child/Adolescent Intake Application

Child/Adolescent Information Form

Problem Checklist, Parent Form

Certificate of Custody & Authorization

Signature Sheet