Need help with Health Insurance? Click here!
Support Us

Patient Resources

Forms

Release of Information Authorization Form

ROI Form

Medical History Form

Pediatric Adult Male Adult Female

Other Forms

Patient Comment Form  Sliding Fee Application

Medical Telehealth Consent Form 03272020

Bring to Your Visit

  • Photo I.D.
  • Insurance Card
  • Containers of current medications, vitamins & supplements
  • Sliding fee scale applicants – proof of income
  • Release of Information (ROI) form
Download ROI Form

What's New

LSCHC Give to the Max Day

Give to the Max Day is Nov 21 but you can donate early to support LSCHC in providing quality health care to all, regardless of ability to pay. Your support can make a big difference!  Please visit here       https://www.givemn.org/organization/Lschc   #givetomax2024 #lschc2024 #lakesuperiorcommunityhealthcenter  

Treating at LSCHC and Flu Shots

Come and Trick or Treat at our 2222 East 5th Street Superior location and our Duluth location, 4325 Grand Avenue from 3 pm to 5 pm on Thursday, October 31st. We can't wait to see your costumes! Viruses can get pretty S-Poo-KYYY too! Get your FLU shot too BOO! #lschc2024 … Read More +

All Updates

This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

Land Acknowledgment Statement

We acknowledge that our clinics are located on traditional, ancestral, and contemporary lands of Indigenous people who cared for and called these lands home for generations. Our clinics reside on Ojibwe and Dakota lands, and we recognize that the spirit of the Ojibwe and Dakota permeates these lands. The land we reside on has great spiritual and historical significance for Indigenous peoples past and present. We strive to build tribal relations and support tribal sovereignty in our community.

Lake Superior Community Health Clinic complies with applicable federal civil rights laws, and does not discriminate on the basis of race, color, national origin, age, disabilities, sex, sexual orientation, or gender identity.