The three forms in the red section below are to be completed by new patients.

Further down the page in the white section, you will find the two release of information forms to be completed if you would like to send health records in or out of Integracare. 

All forms can be completed/submitted online, or they can be printed and brought into the office. 

Patient Intake Form

This paperwork asks about your symptoms that you will be seen for during your appointment.

Consent to Treat

This consent to treat must be signed prior to receiving care at the clinic. 

Patient Notice

This notice must be signed prior to receiving care at the clinic. This is our HIPAA paperwork.

Release of Information Forms

Sending Records OUT of Integracare

To be completed when requesting Williams Integracare send the information to another medical facility. 

Sending Records INTO Integracare

To be completed when sending information to Williams Integracare from another medical facility.

williams integracare footer logo

Phone: (320) 251-2600
Fax: (320) 251-4763
Email: info@integracareclinics.com
Clinic Hours: M/W 8am-6pm & Tu/Th/F 7am-5pm

Copyright 2024, Integracare LTD, All Rights Reserved. Information on this website should not be regarded as medical advice.