Before you get started, please complete:
We take privacy very seriously in our office. Please review our Notice of Privacy Practices form below. Then, download and sign the Acknowledgement of Receipt of Notice of Privacy Practices. You’ll bring this form in with you when you come to our office.
Complete and sign the following forms prior to your first visit. After completion, fax to (651) 356-8486 or mail them back to the office. Bring all forms with you for your first visit.
Office Forms:
Clinic Forms:
After Dr. Gilles has reviewed your intake information, you will be notified as to which specific questionnaires to complete prior to your child’s visit. Please email or fax these back to the office before the visit.
Please complete the What do you need? questionnaire again so Dr. Gilles can best address your current concerns.
Please complete the PHG-9 and GAD-7 each visit if your child is verbal and less than 13 years old and by the the child themselves if verbal and older than 13 years of age.
If your insurance information has changed, please notify the office.
Next Step in Care, a program developed through the United Hospital Fund, has a very helpful overview of how you can get the most out of seeing a doctor.
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