Clinic Forms

Click on the links below to print off a copy of our Intake Form and Consent to Disclose form.

Please note that the client/patient must bring the intake forms to their initial visit at Mamaway Wiidokdaadwin Primary Care Clinic.

Phone to book your appointment at either location.

Mamaway Intake Form

Consent to Disclose PHI June 2019

Referral Consent Form

Feel free to contact our clinics for more information.