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  • Home
  • About Us
    • Our Mission
    • Board of Directors
  • Our Services
  • Our Clinics
  • Our Providers
  • Foundation
  • Giving
  • Contact Us

Clinic Patient Forms

Clinic Patient Formsmcgadmin2019-08-01T14:00:18+00:00

  • ADHD Symptom Checklist

  • Adult Depression Screening
  • Bone Density Order Form
  • Child/Adolescent Depression Screening
  • Geriatric Depression Scale
  • M Chat
  • MRI Screening Form
  • Sleep Study Referral Form
  • Sleep History Questionnaire
The Faulkton Area Medical Center provides equal opportunity to anyone seeking our services or visiting our facilities. If you need an accommodation because of a disability, please contact Clinic Reception at 605-598-6262 at least 72 hours in advance of the need for the accommodation.

Important Links

Job Openings
Patient Forms
2020 Community Health Needs Assessment Report
2017 Community Health Needs Assessment Report
Insurance/Medicare Information
FAMC 2019 990
FAMC 2018 990
FAMC 2018 Single Audit
Pharmacy Charge Master
Hospital Charge Master
Shoppable Services
Release of Medical Information Form

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