Doctor Checking a Form

Client Forms

The forms below can be filled out and submitted directly to Northern Pines online: 

The forms below can be viewed for reference, or printed.  You can also use them to follow along while our staff complete the form for you:

Client Info Adult

Client Info Child

Privacy Practice


Treatment Consent


Telehealth Consent

Financial Policy

Form Letter for Birth to 5 program

Intake Screen Ages 4-10

Intake Screen Ages 11-17

Intake Screen Adult

Ages and Stages Questionnaire

These Forms are in PDF format you will need Adobe Reader to view them


You can get Adobe Reader Here

MN Crisis Text Line
Minnesota Farm & Rural Helpline