Request an Appointment

After you’ve submitted this request, we will call you within one to two business days to help you make an appointment.

You can also make an appointment by calling 218-463-2500.

First Name(Required)

Middle Initial

Last Name(Required)

Gender(Required)

Date of Birth(Required)

Address

City

State

Zip Code

Phone Number(Required)

Email Address(Required)

Contact Information

Contact Name (If different from the patients name)

Contact Phone Number

Contact Email Address

Appointment Information

Has the patient seen a LifeCare provider before?

Do you know which provider you would like to see?

Provider Specialty

Insurance

Reason for Appointment(Required)

Would you like us to look for providers near a specific address, such as your home or workplace? If so, please list the address.

How did you hear about us?

Manage your care

MyChart

Your MyChart account allows you to:

Schedule Appointments
Get Virtual Care
Check-In Online
Fill Prescriptions
Message Your Provider

Request an Appointment

Contact Information

Appointment Information

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