Minnesota Masonic Charities provides important services and contributes to many charitable causes in the name of Minnesota Masonry.

952.948.6200

Minnesota Masonic Home’s mission is to provide compassionate, quality care and services to aging adults.

952.948.7000

The lush, 83-acre campus in Bloomington, Minnesota is centrally located, easy to access, and offers everything you need for your special event.

952.948.6500

Providing compassionate and effective identification, treatment and support for childhood communication disorders.

218.720.3911

Forms

The Minnesota Masonic Children’s Clinic for Communication Disorders must collect personal information from individuals in order to effectively evaluate them for services. We are careful to protect the privacy of our patients and their families, and we ask that no personal information be sent via email.

The forms below are provided so that families may download and complete admitting information, before printing the forms out and returning them to us through the U.S. Postal Service or in person at our clinic.

Please contact us if you are unclear about the forms you need.

Case History Form

Media Consent & Release Form

Consent for Release of Confidential Information