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New Patients: 218.249.4000

OB-GYN Pre-Registration

Forms for your appointment

If you have an appointment with a St. Luke’s OB-GYN provider, please fill out all four of these forms. This will help reduce your wait time once you are at the clinic.

You can print off the forms and bring them in to your appointment. Alternatively, you may email the completed forms to SLHOBGYNclinic@slhduluth.com. Please note that this email is not secure, and the email could be intercepted by a third party.

If you have any questions regarding these forms, please call 218.249.4700.

St. Luke’s OB-GYN Patient Intake Form

Consent for Service

Special Needs

Permission to Verbally Discuss Protected Health Information