55 1st Ave E Turtle Lake, ND 58575 

Patient Portal

To speak with a nurse after hours please call: 877-609-3577

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Request an Appointment
Patient forms page for Northland Health Centers with new patient registration, behavioral health, dental, sports physical, DOT, consent, and release of information forms.

General New Patient Forms

Before you are seen by one of our providers, we will need some basic information. We will need your current legal photo ID, your health insurance, Medicaid, and/or Medicare card, and for you to complete a medical history form.

Patient Registration Form
Behavioral Health Intake Form
Behavioral Health Informed Consent Form
Dental Health History Form
Northland Cares Program
DOT Physical Form
NDHSAA Sports Physical Form
Authorization to Treat Unaccompanied Minor
Release of Information

We can even provide services to you if you do not have insurance! We encourage all patients, regardless of their insurance or financial status, to apply for our Northland Cares Program. The application process is simple and takes no more than a few minutes to complete. Our Northland Cares Application is used to determine if you and/or your family qualify based on your family size and income. Team members at any of our clinic sites can explain the details of applying for our Northland Cares programs or you can contact our Eligibility Coordinator at 701-448-2054. You must provide proof of income when applying for discounted services. Learn more here

Team members at any of our clinics are happy to help you make a medical appointment. You will be asked to provide your name, address, phone number, Date of Birth (DOB) and insurance information.