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Ellsworth Medical Clinic
715-273-5041
1-800-514-9206
 
River Falls Medical Clinic
715-425-6701
1-800-514-9204
 
Spring Valley Medical Clinic
715-778-5591
1-800-514-9208
 
A Division of
Western Wisconson
Medical Association, S.C.
Online Forms

We ask that new patients arrive 15 minutes before their scheduled appointment to allow for the completion of registration paperwork, including gathering insurance information.

For your convenience, you may download the forms below to fill out before you come in. The forms are provided in PDF format, which require Acrobat Reader (download free).

Patient Forms
Authorization for Use and Disclosure of Patient Health Information
Guide to International Travel
Patient Health History Form

 

 


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