We have made all the necessary forms available for download/printing here on the web site for your convenience. These forms were designed in an Adobe PDF format. If you don't have adobe acrobat reader, you can download the free software using the link at the bottom of this page.

If you have any questions while filling our these forms please call our office at 952-345-3000.

*Download Maps Here* - Click here To download a PDF document to all NDBC locations!

NEW PATIENT FORMS

1. Medical History Form
For an Adobe PDF document

2. Dizziness Handicap Index (DHI)
For an Adobe PDF document

3. Patient Consent Form
For an Adobe PDF document

4. Health Insurance Verification Form
For an Adobe PDF document

5. Computerized Posturography (CDP) Waiver Form
For an Adobe PDF document

CLINIC POLICY FORMS

1. Attendence Policy
For an Adobe PDF document

2. Privacy Policy
For an Adobe PDF document

ORDER FORM FOR YOUR PHYSICIAN (if needed)

Referral Order form:
For an Adobe PDF document

RELEASE OF MEDICAL RECORDS WAIVER FORMS

1. Release Form - For Releasing Your Records
For an Adobe PDF document

APPOINTMENT BROCHURES/INSTRUCTIONS

1. Brochure - Comprehensive Evaluation
For an Adobe PDF document, page 1 Page 2

2. Brochure - Audiology Balance Lab Evaluation
For an Adobe PDF document, Page 1 Page 2

3. Brochure - Physical Therapy Evaluation
For an Adobe PDF document, Page 1 Page 2

**NOTE: To print brochures:
1. Click on the link above to open the brochure image in a new window
2. After the brochure loads, right click your mouse
3. Select "save picture as", and then choose desktop as location to "save in" from the menu
4. Open the file from your desktop on your computer by double clicking on the file
3. Then choose the printer icon and follow the basic instructions to print brochure

Click here to download Adobe Acrobat reader