FamilyHealth Medical Clinic

Patient Resource Center

2009 Childbirth Education Class Schedule
2010 Childbirth Education Class Schedule

2009 Immunization Schedule for Children and Adolescents (Minnesota Department of Health)
New: For Fall 2009, two doses of the varicella (chicken pox) vaccine are required for kindergarten or 7th grade. Learn more here »

Physician presentations

Women's Health: Fact and Fiction – Melanie H. Dixon, MD
What Men Need to Know and You Should Tell Them! – Brad Johnson, MD
Health 1-2-3s for Families – Michele Erickson, MD, & Julia Kelley, MD
To Shot or Not – The Facts About Immunizations and Vaccines – Patrick Enders, MD

New Patient Forms

Adult Patient Information Form: A pdf version of a medical history form that you can print out, fill in and bring with you to the clinic.

Obstetric Medical History Form and Personal and Family History Form: pdf forms that you can print out, fill in and bring with you to the clinic.

Pediatric Medical History Forms: A pdf version of a medical history form for a child that you can print out, fill in and bring with you to the clinic. Please select the appropriate form based on your child's current age:

Authorization for Disclosure of Medical Information: A pdf version of an Authorization for Disclosure of Medical Information form that may be used to have your records transferred from another medical care provider to FamilyHealth Medical Clinic. Please fill it out, sign it, and submit it to your previous provider.

Adult Health Maintenance Form : A pdf version of a record of your immunizations, lab work and diagnostics that you can print out, fill in and bring with you to the clinic.

Other Forms

Minor Consent Form: A pdf version of a parent/guardian's authorization for someone else to bring their child to the clinic for medical care and treatment.

Authorization for Disclosure of Medical Information to other medical providers:

A pdf version of an an Authorization for Disclosure of Medical Information form that may be used to have your records from Northfield Hospital & Clinics (including FamilyHealth Medical Clinic) transferred to another medical care provider. Please print and fill it out, sign it, and submit it to the clinic that has the records you want transferred.

Living Will

Health Care Directive: A pdf version of a Health Care Directive form that you can print out.

Health Care Directive attachment – Healthcare Instructions: A fillable PDF you can download, fill out on your computer, save and print.

Diagnostic Imaging

The following brochures provide answers to frequently asked questions about common diagnostic imaging procedures. They may be downloaded in pdf format.

Diagnostic Ultrasound

Nuclear Medicine Testing

CT Scanning

MRI Scanning

Upper GI Series

Small Bowel Follow-Through

Modified Barium Swallow or Esophagram

Intravenous Pyelogram

Barium Enema and Air Contrast Barium Enema

Cardiac Stress Tests

To help you learn what to expect from your cardiac stress test, please download one of the pdf files below:

Cardiac Stress Test (Basic Exercise Walking Test)