New Patient Forms

First-time patient? Save time at your appointment by filling out our Patient Registration, Medical Record Release, and HIPAA (Medical Information Disclosure) forms..

Prior to your appointment, we prefer that you fill out the New Patient Registration form. You can download and print the PDF version found below, fill it out, and bring it with you to your first appointment. You may also scan your form and email it back to us.

PLEASE NOTE: If you are a new patient, please call the office at 608.437.3377 to schedule an appointment before filling out the New Patient Registration Form. Thank you.

• New Patient Registration Form (downloadable PDF file for printing)
• Medical Records Release Form
• HIPAA (Medical Information Disclosure) Form
• Financial Responsibility Form  (NOTE: If patient is under 18, please have parent/responsible party sign form)
• Contact Lens Policy Agreement (only for contact lens wearers)