IPC-MN Client Intake Form

Client Here for Appointment

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Insurance Information

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Insured/Policyholder Information

Visits & Emails

I.P.C. will send all invoices to the email you are providing. Invoices come as a PDF attachment. These emails will come from dorian@ipc-mn.com Please add this email to your safe sender list to avoid spam blockers from intercepting your email invoice. By providing your email address above, you are consenting to having invoices sent via email and acknowledge the risks inherent to email transmissions.

I.P.C. will also add you email to our newsletter where important information and resources are shared. If you want to specifically opt out of emailed invoices or our newsletter, please indicate below.

Email Permission