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Medical and Vision Forms

If your provider has indicated that you need to complete forms found online, please print and fill out the necessary forms below. 

Si su provedor de salud le ha indicado que usted complete formularios en linea, por favor sirvase a llenar estos formularios en los enlaces de abajo.

Formularios Médicos y de Visión

Contact Information

Medical (612) 827-7181

Oral Health (612) 822-9030

Oral Health E. Lake St (612)-821-2017

Vision (612) 821-2003

Behavioral Health (612) 827-7181

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Fax Medical and BH (612) 767-4545

Fax Oral Health and Vision (612) 821-2818

Fax Oral Health E. Lake St 

(612)-568-0164

Locations

Southside Medical, Behavioral Health, Vision, & Oral Health

1000 East Lake Street

Minneapolis, MN 55407

 

Oral Health

4243 4th Ave South 

Minneapolis, MN 55409

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Southside is an FTCA Deemed Facility

This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).

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All patients have the right to receive considerate, respectful delivery of care regardless of age, race, color, national origin, culture, ethnicity, language, socioeconomic status, religion, physical or mental disability,  insurance status, or ability to pay for services.

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No one is ever turned away for the inability to pay. Southside Community Health Services (Southside) is a 501c (3) nonprofit, federally qualified health center (FQHC) providing access to primary care to anyone in need in South Minneapolis and the surrounding areas.

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