Phone: 262-255-1550
W172 N9723 Division Road
Germantown, Wisconsin 53022

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Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment.

New Patient History Form

COVID-19 forms

Supplemental Informed Consent
https://assets-prod-www1.aaoinfo.org/assets-prod-www1/2020/04/AAOIC-SUPPLEMENTAL-INFORMED-CONSENT-final-1-1.pdf

Supplemental Health Questionnaire
https://assets-prod-www1.aaoinfo.org/assets-prod-www1/2020/04/SUPPLEMENTAL-HEALTH-QUESTIONNAIRE-4-19-Final-1.pdf

What Our Patients Say!

We have found our visits to the office to be comforting and professional. The staff are always smiling, polite, and attentive to our needs. Dr. Daub takes time to inquire and explain procedures. We are looking forward to the finished product. I’m sure it will be a work of art! ~ Amy K.

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W172 N9723 Division Road
Germantown, Wisconsin 53022

Phone: 262-255-1550
E-mail: [email protected]

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