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Cass County Health Clinic Telemedicine Forms PC

Please select the forms you need to fill out and follow the instructions below to fill out the form and submit it to our clinic email.

Consent to Participate in a Telemedicine Appointment

Adult 18+

Child - Under 18

Behavioral Health

If you are using a computer with Google Chrome as your browser:

Download and install Adobe Acrobat Reader DC here: https://get.adobe.com/reader/

Select download Acrobat reader and follow the instructions to install.

Once the program is installed, select your forms from the list.

When you click on your form it will open in a new window in your browser. You will not be able to complete or submit the form from this page.

Select the download button from the upper right corner.

Save the file to your desired location.

Once you save it, it should open up in Adobe Acrobat Reader DC and your screen should look like this:

If it does not open up immediately, find the file where you saved it and right click on it.  Select open with and then Adobe Acrobat Reader DC and then you should get the screen above.

Once your form is open in Adobe Acrobat Reader DC you should be able to fill it out. Be sure to scroll all the way to the bottom to make sure you have the form filled out completely. Once you are done select the submit button in the top right corner.

Next you'll need to send the form to us using your email. In this example our website admin used her address, but you'll replace email address with yours and Full Name with your full name and then hit send.

Next you'll add your email account. Just follow the instructions based on what type of email address you have. Our admin has a gmail account but you can use Microsoft Outlook or add another type of address (yahoo, etc.) by selecting other and following the instructions from there.

Next you'll select your address and hit continue.

At this point you'll need to sign into your email account. With Gmail, sign in with your Gmail Account with your email and password and when it comes up with this screen asking you to give permission to Adobe Acrobat to send emails on your behalf. Select Allow.

Select OK on the Adobe Acrobat and that will send your response to our clinic email account. 

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