Forms
If filling out forms digitally, you will need Adobe Acrobat Reader to properly sign documents. Otherwise, we encourage clients to print off and fill out documentation before their appointment. Forms are also available at locations and can be filled out in lobby.
Once forms are completed, please email them to care@cmmhc.com with the subject line being the name of the provider requesting the information.
New Clients Forms
- English Notice of Privacy Practices
- Somali Notice of Privacy Practices – Ogaysiiska Habraaca Xafidida Xogta
- Spanish Notice of Privacy Practices – Aviso de Prácticas de Privacidad
- Billing Policies
- Client Guidelines
- Complaints & Grievances
- Patient Bill of Rights
- Therapist Rights
- Client Welcome Packet
- Sliding Fee Policy
- Sliding Fee Scale
Psychiatry Forms
Forms for Adults (ages 18+)
Forms for Ages 11 – 17
Forms for Ages 6 – 10
Consent and Release Forms
Telehealth Forms
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Right to Privacy
Central Minnesota Mental Health Center supports every client’s right to privacy and it is the responsibility of everyone to protect it. Central Minnesota Mental Health Center’s clients have access to and control over their protected health information. Responsible use of clients’ protected health information by all employees at CMMHC will help improve health care by increasing trust in the system.
Together, Creating a Healthier Life
Do you or someone you know struggle with chemical or mental health symptoms? Do you want to reach out but aren’t sure where to turn?
We’re here to help.
Crisis Services are available 24/7, 365 at 320.253.5555.
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