1-612-869-4444 5939 Portland Ave S, Minneapolis, MN   |  M-F 8:30am - 4:00pm

Intake Forms

This intake form is required for all new patients seeking to establish care at Diamond Lake Clinic. You may request a fillable Adobe version by emailing info@diamondlakeclinic.org, return a printed and completed form to our Minneapolis location, or email the completed paper form to info@diamondlakeclinic.org. All forms must be completed in full and submitted with photos of your insurance card and photo ID, either attached to the Adobe online form or included with your emailed submission.

This combined questionnaire form helps screen for symptoms of depression and anxiety and how they may be affecting your daily life. Your responses provide important insight to support accurate assessment and personalized treatment planning during your appointments with your assigned provider.

It is required for each Spravato administration appointment and one time per week for TMS sessions, in addition to at the request of your providers

This telecommunications consent form provides your consent for our clinic to communicate with you via phone calls, text messages, and email regarding appointments, treatment updates, billing, and other important information related to your care. Your preferences help us communicate with you in a way that is convenient while maintaining your privacy.