*** Forms for Bluestem Patients Only ***
New Patient Paperwork ‐ Kids 11 and Under
Please check with Bluestem prior to completing any New Patient Paperwork.
Patient Information and Policies Brochure
Authorization for Treatment of Minors (Signatures)
New Patient Paperwork- Adolescents 12 and over
Please check with Bluestem prior to completing any New Patient Paperwork.
Patient Information and Policies Brochure
Authorization for Treatment of Minors (Signatures)
Adolescent Confidentiality Form: Teen Version
Adolescent Confidentiality Form: Parent Version
Understanding of Confidentiality Agreement (Signatures)
New Patient Paperwork- Adults
Please check with Bluestem prior to completing any New Patient Paperwork.
Patient Information and Policies Brochure
Other Forms
Adolescent Confidentiality Agreement - Parent Version
Adolescent Confidentiality Agreement - Teen Version
Release of Information - Bluestem Form
Release of Information - Mayo Form
Release of Information - Olmsted Form
School & Behavior Problems Checklist- For Teachers
Understanding of Confidentiality Agreement