Home Visits Intake

​​​​​​​​​​​​​​​​​​​​​Please complete the following information to refer yourself or someone else for Family Health Services. Information entered on the referral form will be provided to all selected services.

If you have any questions or need assistance contact phintake@co.dakota.mn.us or 651-554-6115.   Discharge summaries or additional information can be faxed to 651-554-6130 or emailed to phintake@co.dakota.mn.us.

For general information regarding services offered, go to the following pages:

• Asthma
• Child and Teen Checkups
• Family Home Visiting
• Follow Along Program
  
• Mothers an​d Babies
  
• Women, Infants and Children​

Complete ​Home Visit Referral Form​

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