Adult and Pediatric Wellness Care

Yearly wellness visit: an otherwise healthy adult or pediatric patient with no other reason to come into the doctor’s office other than to review current health and recommendations for usual care throughout the year. This visit might include vision, hearing, development and weight assessment, screening questions for illness/disease, and physical examination. Forms for camp, daycare, athletics, etc. will be completed at this visit as well. Any vaccinations or laboratory testing incur additional charges.

Nurse-only visit: In some cases, you do not need to see a healthcare provider. For an established patient, our nursing team will coordinate a number of healthcare services. All nurse-only visits receive provider review with nurse follow-up information provided. In some cases, providers may request an appointment if additional care is required/requested.

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Integrative Care for Adults and Children

All New Kingdom providers and staff recognize the importance of considering traditional western medicine options and welcome discussions of alternative care modalities. And, we have these discussions without judgment. While some families come to our clinic and wish to receive only traditional medical care options (we provide all routine care found in the traditional medical clinic), other families are on a “health and wellness journey” – we are prepared to be your tour guide and support on that journey.

We understand that each family is unique, with their own set of healthcare needs and preferences. That’s why we take the time to get to know our patients and their families on a personal level, so that we can provide the best possible care. Our providers and staff recognize the importance of considering all medical options for you.

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Our Providers

Employment Application

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Are you legally allowed to work in the U.S.?(Required)
Desired type of employment(Required)
Are you able to work weekends?(Required)
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Request Employment Verification

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Address Change

Change your address by filling out the form below:

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New Address

Personal Info and w-4 Upload

Company Holidays (Office Closed)

  • New Years Day
  • Easter
  • Memorial Day
  • Independence Day
  • Labor Day
  • Thanksgiving
  • Christmas Day

$250 Employee Healthcare Benefit

For information regarding your $250 EE healthcare benefit and how to use, please contact Emily Walters who will assist you through the process. ewalters@newkingdomhealthcare.com

W-4 Forms

If you need to download and print the W-4 forms, please click here to view and print.

https://www.irs.gov/pub/irs-pdf/fw4.pdf

https://www.revenue.state.mn.us/sites/default/files/2022-01/w-4mn.pdf

If you have filled out both your Federal and Minnesota W-4 form and are ready to submit, please attach the form now.

Update your W-4 by filling out the form below:

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InterPreter Request

Please Give Two Weeks Notice For Interpreter Request

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Date / Time the Interpreter is Needed

401K Enrollment Form

Please complete the employee sections of the enrollment form found at this link. Click here.

Once you have completed the form, please attach and submit for processing.  You will be notified once your account is setup.

Here are some things to keep in mind:

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Direct Deposit

Use this form to setup or update your Direct Deposit information. Contact Karissa at klucas@newkingdomhealthcare.com with any questions.

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Name of Financial Institution
Account Type
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Name of Financial Institution
Account 2 Type
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Submit W-4 Info

W-4 Forms

If you need to download and print the W-4 forms, please click here to view and print.

https://www.irs.gov/pub/irs-pdf/fw4.pdf

https://www.revenue.state.mn.us/sites/default/files/2022-01/w-4mn.pdf

If you have filled out both your Federal and Minnesota W-4 form and are ready to submit, please attach the form now.

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Payroll Setup Form

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Address

New Hire Request Form

Use this form to make a new hire request. If you have any questions, please contact klucas@newkingdomhealthcare.com.

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Legal

Please describe the situation and submit for Jeffrey to review. If you have questions, please contact Jeffrey at jplombon@newkingdomhealthcare.com

Patient Complaints

Please provide the following information and we will follow up on the complaint. If you have any questions, please contact Karissa Lucas at klucas@newkingdomhealthcare.com

Technical Support Ticket

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Issue / Request Type

Lab Supply Order

Please complete the following information to have your lab supply order processed. If you have any questions, please contact Shelly at skloos@newkingdomhealthcare.com

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Supply Order Request

Please use this form to place a supply order request. Contact Charlene at cwells@newkingdomhealthcare.com with any questions.

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Maintenance Request

Please provide the following information and Jeffrey will be in touch with you shortly regarding your request.

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Fill Out Your Records Request Below

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Fill Out Your Form Request Below

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Fill Out Your Billing Request Below

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