Patient Access Forms

Easily accessible forms for patients to streamline their experience at our medical office.

New Patient Packet

If you are a New Patient, please complete these forms prior to your first office appointment.

Medical Records Request

Use this form if you would like your health information released from UWSMA.

Please complete this form describing your privacy rights.

Patient Privacy Form

Health Information Request to Primary Physician

Use this form if you would like your health information released from an organization to UWSMA.