Patient Forms

What to bring to your first appointment

​If you have insurance, please bring your insurance card or other proof of insurance. If you do not have insurance, please contact our business office at 414-640-5433 before your first visit.

 

For Sliding Scale discounts bring proof of income, such as  pay stub, income tax form, letter from employer

Download, print and fill out the following form and bring them to your first appointment.

  • Download, print and fill out the following form and bring them to your first appointment.
     

 

 

Please email completed forms to contact@shalemhealing.org