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New Patient Form for Family Member

**We currently have a 4-6 week waitlist for new patients. If you would like to be added to our waitlist, complete the form below. Thank you for connecting with us and we look forward to helping you with your journey. 

Patient Information

Your Information 

Patient Information

Thanks for submitting!

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Connect with us

Ironwood Square Building

300 3rd Ave SE Suite 302

Rochester, Mn 55904

(P): 507-703-6377

(F):  507-353-0566

**If you completed the new patient form, you do not have to fill out the 'connect with us' information box. 

"Like a lotus flower, we too have the ability to rise from the mud, bloom out of the darkness and radiate into the world."

-unknown-

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