Forms
Make your office visit easier! This will speed up the paperwork and shorten the time it takes to see one of our pediatricians. If you don't have Adobe Reader™ please download it here. It is a free software application.
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Authorization to Release Protected Health InformationThis form is needed on the patients first visit. This form can be filled out within Adobe Reader™ and printed out. This will speed up the administrative process and shorten the time it takes to see one of our pediatricians. |
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Patient Authorization Form for Medical ServicesThis form is needed on the patients first visit. This form can be filled out within Adobe Reader™ and printed out. This will speed up the administrative process and shorten the time it takes to see one of our pediatricians. |
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ADHD Follow-Up ReportThis form can be filled out within Adobe Reader™ and printed out. This will speed up the administrative process and shorten the time it takes to see one of our pediatricians. |
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Social Developmental Screening -24 MonthsThis form can be filled out within Adobe Reader™ and printed out. This will speed up the administrative process and shorten the time it takes to see one of our pediatricians. |
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Social Developmental Screening-18 MonthsThis form can be filled out within Adobe Reader™ and printed out. This will speed up the administrative process and shorten the time it takes to see one of our pediatricians. |
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Who Should I Call When the Clinic is Closed?This form is a contact list of phone numbers when the office is closed. |
Office Hours
Monday-Tuesday: 8:30am - 7:30pmWednesday: 8:30am - noon
Thursday - Friday: 8:30am - 5pm
If the clinic is closed, still call our office - one of the physicians will answer!
Trusted Partners
U of M Amplatz Children's Hospital
KidsDoc Sympton Checker
Childrens Physician Network
Fairview Physician Associates
American Academy of Pediatrics
News and Social Media
Children's Health
View our care philosophy and how we are perfect for you and your children
[ click here ]
VEP Machine - Visual Evoked Potential
Mendakota Pediatrics is one of a few offices in the metro that have this critical eye test.
[ learn more ]
