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Northern Prairie Community Clinic
Northern Prairie Community Clinic
Northern Prairie Community Clinic
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Forms

Due to HIPAA and Confidentiality we are not able to accept emails from clients or their families. If you have any documents which need to be received by your clinician or the clinic, please send them via regular USPS mail or fax. Thank you.

NPCC Forms

  • Confidentiality
  • HIPAA
  • Release of Information
  • Telehealth Client Handout

NPCC Mental Health Forms

  • Payment Agreement
  • Telehealth Mental Health Consent - Adult
  • Telehealth Mental Health Consent - Minor
  • Temporary Fee Reduction Request Policy

NPCC Speech Language Pathology Forms

  • Financial Assistance Policy
  • Financial Assistance Application
  • Telehealth Speech Consent - Adult
  • Telehealth Speech Consent - Minor
Northern Prairie Community Clinic
Columbia Hall Room 1300
501 N Columbia Rd Stop 7132
Grand Forks, ND 58202-7132
P 701.777.3745
F 701.777.3845

Clinic Hours

Monday - Thursday
8 a.m. - 8 p.m.

Friday
8 a.m. - 4 p.m.

NPCC is closed during all UND holidays and weather closures.

Emergencies

Dial 911 for 24-hour crisis care.

Crisis Line
701.775.0525

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