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Want to apply for no-cost birth control? Need a copy of your medical records?  Find the form you need below.

No-Cost Birth Control Application

Medical Records Release Forms

Need a copy of your medical records? Please read the descriptions below and fill out the form that applies to you, then fax the completed form to 651-696-5543 or scan to [email protected]

Minnesota Clinic Patients

South Dakota Clinic Patients

 

Questions about which form to fill out? Give us a call at 1-800-268-9150.