Patient Information

We have made our patient forms available to you as Adobe Acrobat files for your convenience. When you click on the name of the form, it will automatically open in Acrobat Reader. Make sure you use the print button in Acrobat so the forms will print correctly.

New Patient Forms
Please see below to find a list of downloadable forms that will help you get started as a new patient with Eau Claire Medical Clinic. All other forms will be provided to you upon your first visit with us. For further information, please call (715) 839-9280.



General Forms

Patient Information and History Form

Statement of Financial Responsibility

Authorization For Disclosure of Health Information

If you don't have Abobe Acrobat installed on your computer please download a free version from Adobe.