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420 East Narnia Street, Suite 2100 Winona, MN 55987 info@hvmhc.org www.hvmhc.orgSchool Based/Linked Mental Health Services Referral Form Date ___ Services Requested by: ___Phone:___ Student (Client)
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Hiawatha Valley Mental Health Center is a non-profit organization that provides mental health services to individuals in southeastern Minnesota.
Certain healthcare providers and facilities are required to file reports with Hiawatha Valley Mental Health Center.
You can fill out the form online or submit it by mail to the designated address.
The purpose of Hiawatha Valley Mental Health Center is to provide mental health services to individuals in need.
Providers must report information regarding the type of services provided, number of patients served, and outcomes of treatment.
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