Patient Forms
Click below to access printable versions of our forms.
Medical Records Forms
Radiology Forms
Medical Center Forms
Dental Center Forms
- Registration
- Registration (Spanish)
- Acknowledgment of Receipt of Privacy Notice
- Acknowledgment of Receipt of Privacy Notice (Spanish)
- Release of Dental Information Verbal
- Medical History
- Medical History (Spanish)
- Dental History
- Dental History (Spanish)
- Dental Record Release Form
- Privacy Practice Pamphlet
- Financial Guidelines Policy
- Financial Guidelines Policy (Spanish)
- White Smile Enrollment (English)
- White Smiles Enrollment (Spanish)
All forms should be mailed to:
Wisconsin Health Fund
6200 W. Bluemound Road,
Milwaukee WI 53213
Clinics & Pharmacy
Learn more about our Medical Center, Pharmacy, and Dental Center. Delivering the very best in health care services.
Member Benefits
Learn more about benefits available to member organizations covered by Wisconsin Health Fund.