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New Patient Package

new patientSave yourself some time by downloading, printing and filling out our New-Patient Package prior to your visit. Simply bring the forms with you to your first appointment and you will be able to sit back and relax. If you have any questions about the forms themselves, please feel free to call us at 262.634.4646 – we’re always happy to help!

PDF iconNew-Patient Package: contains the forms that will be needed for your care and will help to expedite your appointment with Dr. Wagner.

PDF iconPatient Registration Form: part of the New Patient Package. Available here for separate download.

PDF iconMedical History Form: part of the New Patient Package. Available here for separate download.

PDF iconMedication List Form: part of the New Patient Package. Available here for separate download.

get Adobe readerThe above forms are saved in PDF format. If you are unable to view them, please download and install the free Adobe Reader software.

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