Registration Forms

Thank you for making an appointment with Laura Wagner, Inc. 
Your privacy is important to use.  Our Notice of Privacy Practices is available on our website and in our office. You should read it in full. 

New Patients:
When you make your appointment, we will pre-register you verbally in order to cut down on forms. We will ask you to complete a Health Form and the two Consent Forms for your first appointment. We usually email the necessary forms to you before your appointment.  If we are not able to email them, they are available for printing below.

• Please arrive 10 minutes before your appointment.
• Bring your completed forms, insurance card(s) and driver's license. Have them in hand and give them to Wendi at the front desk.
• If you have a medication list, you can bring it and we will attach a copy of it to your health form instead of listing them on your health form.

Established Patients:
We will pre-register you over the phone before your appointment. We verify all demographic information in order to capture any changes that may have occured since your last appointment. We ask patients to update their Health Form yearly and Consent Forms when there has been a change to our form or at least every 3 years.  If we need any forms from you, we usually email them to you.  If we are not able to email them, the forms are available for printing below.  We appreciate your cooperation in providing this information to us.

• Please arrive 10 minutes before your appointment.
• Bring any completed forms that we have asked for, and your insurance card(s)  Have them in hand and give them to Wendi at the front desk.
• If you have a medication list, you can bring it and we will attach a copy of it to your health form instead of listing them on your health form.

Please print, complete and sign the following forms and bring them with you to your next appointment.  

VIEW and PRINT Forms Here: