Required forms

You must complete some forms before you can receive services at a Minneapolis School Based Clinic. Get them online or at the clinic.

View and download general forms

You can download forms in many languages. We tell you how often you need to submit each form and who needs to sign it.

English, Spanish, Somali

Submit once

Parent or guardian and students age 18 and older must sign

English, Spanish, Somali

Submit once

Student signature only

English, Spanish, Somali

Update every year

Student signature only

English, Spanish, Somali, Oromo

Update every year

Student signature only

View and download forms for certain services

You can download forms in many languages. We tell you how often you need to submit each form and who needs to sign it.

English

Good for three years

Student and parent or guardian signature

English, Spanish, Somali

Submit once

Student and parent or guardian signature

English, Spanish, Somali

Submit every time you get a vaccine

Student and parent or guardian signature

Clinic policies

Read about our policies, your rights and more.

Contact us

Minneapolis School Based Clinics

Minneapolis Health Department

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Phone

612-673-2301

Address

Public Service Building
505 Fourth Ave. S., Room 520
Minneapolis, MN 55415