Plymouth Office
12805 Highway 55
Suite 211
Plymouth, MN 55441

ph. 763-550-9005
fax. 763-559-2118

Pequot Lakes Office
PO Box 413
4325 Woodman Street
Suite 200
Pequot Lakes, MN 56472

ph. 218-568-4500
fax. 218-568-8944

Kris Chaffee, Psy D
Tamara Clement, PhD, LP
Kristen Eide, MA, LP
Jeff Glover, MA, LPCC, LADC
Rachel Le, MA
David Mellberg, PhD, LP
Ben Monseth, MA, LMFT
Kari Nelson, PsyD, LP
William Nelson, MD, Psychiatrist
Kathy Paige, MA
Roger Reddan, MA, LP
Breanna Shellum, MA, LMFT
Kathy Slavics, MA, LPC

New Client Paperwork
You are asked to arrive to your first appointment 15-20 minutes early to complete necessary paperwork prior to your first visit. You also have the option of printing the new client paperwork at home and bringing the completed paperwork to your first appointment.

These questions will guide you through which forms you'll need. Please call our office with any questions you may have.

1. Are you scheduled to see a Psychiatrist for medication or a Therapist for talk therapy?

2. Will MPR be billing your insurance for your visits or will you be self pay?

3. If MPR is billing your insurance, do your benefits for outpatient mental health include a deductible of $500.00 or greater?

4. Do you have Medica or United Health Care insurance? If YES, are you an adult or child/adolescent?

Clinic Forms
The following forms are available to download for your convenience.