Family Health Appointment Forms and Information

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Certain forms are required to be completed when you visit Mahube-Otwa Family Health.  We recognize your time is valuable.  You may:  1) Print the forms in the "Required Forms" section below and bring with you to your appointment, or 2) Please arrive 20 minutes before your appointment time and complete the forms.

Required Forms:

The forms are also available in Spanish, under "Downloads" on this page

Health Insurance?

No one is refused Family Health services because of inability to pay; services are based on a sliding fee for scale based upon your income and family size. All incomes and insurances are accepted including: Medical Assistance (MA), MinnesotaCare (MNCare), Minnesota Family Planning Program (MFPP covers family planning services and supplies for men and women between ages 15 and 50), and private health insurances.

If you have questions or need assistance applying for Health Insurance, contact Mahube-Otwa at (218) 847-1385.  We have trained health insurance navigator assistors available to help you.

If you are applying for the Minnesota Family Planning Program (MFPP) for the first time, you will need the following documentation OR only a US Passport:
     * Proof of income for a month/30 days
     * Provide your Social Security Number - click here to request your SSN
     * Provide your Birth Certificate - click here to request birth records
     * Provide your Driver's License, School ID Card or Military ID Card- click here for more information regarding Citizenship and Identity Proofs