Health Care Home Patient Panel
1.
Name
2.
Email and/or phone number
3.
I reside in
Grand Marais
Grand Portage
Gunflint Trail
Hovland
Lutsen
Schroeder
Tofte
Other (please specify)
4.
I am a
Patient of Sawtooth Mountain Clinic
Family Member of a SMC Patient
5.
Have you or a family member received care at SMC within the past year?
Yes
No
6.
Please tell us why you are interested in joining the Health Care Home Patient Panel.
7.
Are there any healthcare topics you wish to address as part of the Health Care Home Panel?
8.
Is there anything else you would like us to know?