Northland Community Health Centers
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  • Our Team
    • Executive Staff
    • Clinical Team
    • Dental Team
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  • Locations
    • Bismarck
    • Bowbells
    • Central Office
    • McClusky
    • Minot Behavioral Health
    • Minot Dental
    • Minot Medical
    • Ray
    • Rolette
    • Rolette Dental
    • St. John
    • Turtle Lake
    • Turtle Lake Dental
  • SERVICES
    • Dental
    • Medical
    • Mental Health
    • MAT Program
    • Outreach & Enrollment
    • Patient Guide >
      • Becoming a Patient
      • Preparing For Your Appointment
      • Your Medical Information
      • Billing Information
    • Healthier You Challenge >
      • Healthier You Points
      • Healthier You Weekly Winners
    • Resources
  • Patient Forms
    • All Patient Forms
    • Dental Forms
    • Adult BH Forms
    • Child & Adolescent BH Forms
    • Psychiatric Patient Forms
  • Careers
    • Career Opportunities
    • Application FAQ's
    • Student Loan Repayment
    • Discover North Dakota
  • EHS Dashboard
  • NHC Store
*Please contact a Northland Health Centers Team Member before completing the following forms, to ensure you are filling out the correct forms and including the correct necessary documentation. 
Dental Forms:
Demographic/Intake Form

​Release of Information Form(Minot Dental)
​

​Release of Information Form(Turtle Lake Dental)
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  • Home
    • About Us
    • Contact Us
    • Donate
  • Our Team
    • Executive Staff
    • Clinical Team
    • Dental Team
    • Mental Health Team
  • Locations
    • Bismarck
    • Bowbells
    • Central Office
    • McClusky
    • Minot Behavioral Health
    • Minot Dental
    • Minot Medical
    • Ray
    • Rolette
    • Rolette Dental
    • St. John
    • Turtle Lake
    • Turtle Lake Dental
  • SERVICES
    • Dental
    • Medical
    • Mental Health
    • MAT Program
    • Outreach & Enrollment
    • Patient Guide >
      • Becoming a Patient
      • Preparing For Your Appointment
      • Your Medical Information
      • Billing Information
    • Healthier You Challenge >
      • Healthier You Points
      • Healthier You Weekly Winners
    • Resources
  • Patient Forms
    • All Patient Forms
    • Dental Forms
    • Adult BH Forms
    • Child & Adolescent BH Forms
    • Psychiatric Patient Forms
  • Careers
    • Career Opportunities
    • Application FAQ's
    • Student Loan Repayment
    • Discover North Dakota
  • EHS Dashboard
  • NHC Store