Client Inquiry

Please complete the Client Inquiry below, and our Admissions Department will get back to you as soon as possible. Click here if you’re looking for the Corrections Application.

Office hours are Monday through Friday 8AM to 4PM.

Walk-in assessments available
Monday – Friday, 8a-2p at 3231 1st Avenue South, Minneapolis, MN 55408
Same day Admission based on funding and space availability.
Walk-ins after 2 p.m. may be delayed until next business day.

Are you the client?*
If not, please enter your name and relation to client, phone number and e-mail
Client's First and Last Name*
Client's Gender
Date of Birth*
MM slash DD slash YYYY
Client's Email*
Client's Phone Number*
I need an assessment to help me get into treatment*
I would prefer my assessment to be:*
- By phone or teleconference
- In person at an MnTC location
- I have recently had an assessment (within the last 30 days) and want to apply for admissions (please have it faxed to 612-823-4913)
Which MnTC service are you inquiring about (select all that apply)?*
- Outpatient treatment (in person)
- Outpatient treatment (teleconference)
- Residential Short Term Treatment (30-90 days)
- Long Term Residential Program (up to 13 months)
Which location do you prefer?*
- Minneapolis (men and women)
- Rochester (men and women)
- Brainerd (men and outpatient-women)
- Duluth (men and outpatient-women)
- Buffalo (teen boys only)
Have you ever attended MnTC?*
Best Time to Contact Me*
Is there anything else we need to know about your situation?*
Preferred method of contact*