Schedule Appointment

Click above to check for immediate openings, otherwise fill out the form below and we will contact you to schedule an appointment. 

Please fill out the form below to request an appointment with Minnesota Mental Health Clinics. You will be contacted to schedule an appointment within the next 3 business hours (Monday – Friday, 9am to 5pm) at the phone number you provided.

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Client Name *

First

Last

Client Date of Birth *

Client Phone Number *

Primary Contact (if different from client)

First

Last

Contact Phone Number

Contact Relationship to Client

Best Time to Contact

Email Address *

Do you have Medicare as your primary or secondary insurance? *

• Yes
• No

Insurance Name

Insurance ID

What service would you like to schedule?Individual TherapyFamily TherapyADHD TestingAdolescent Group TherapyAdult Group Therapy

Do you have a preferred location or locations?

• Apple Valley
• Eagan
• Edina
• Lakeville
• Maplewood
• Minneapolis
• Woodbury

Do you have preferred days and/or times?

Do you have a preferred therapist?

Would you like to be seen in office or via telehealth? *

• In Office
• Telehealth
• Either

Submit