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Additional Resources
Forms and resources
Here you’ll find forms and information you might need before your visit to Melrose Center. We’ll let you know if you need to fill out a form before an appointment.
*Please note that forms must be printed single sided (not double sided).
Initial Assessment Forms
Other Forms
Online medical record request form Verbal disclosure form (PDF) Insurance Benefit Verification - Maple Grove, St. Louis Park & St. Paul Clinics Insurance Benefit Verification - Woodbury & Burnsville Clinics Insurance Benefit Verification for Optum/UBH and Medica/UHC - Maple Grove, St. Louis Park & St. Paul Clinics Pediatric Feeding Clinic Referral Locations