Rum River Counseling, Inc. Appointment Request Form
Note: If you are experiencing a medical emergency please dial 911 to contact local emergency response personnel.
Please be assured that this online appointment request is a secured and confidential area and that information entered and submitted is confidential.
You may also contact us by phone.
Twin Cities area: (763) 482-9598
Attention: If you are not the intended client, please be sure to fill this form out with the appropriate client information.
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CLIENT INFORMATION
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INSURANCE INFORMATION
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CONTACT INFORMATION
You will be contacted by our scheduling coordinator to review additional medical and financial information, including insurance coverage, before an appointment is offered. Please provide contact information below.
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