When you call to schedule your first appointment in Glenwood City, have your personal information ready. Information you provide us will only be used for providing care to you or your family member and includes:

• First, middle and last names as they appear on your birth certificate
• Date of birth used to identify and verify you, as well as differentiate you from other patients who may have the same name
• Social Security number used to organize your information (You have the option not to provide this number; another number may be used in its place.)
• Address
• Telephone number(s)
• Marital status
• Maiden or previous names
• Employer name, address and telephone number
• Emergency contact to call if an emergency occurs while you are in our care, and how to reach them
• Insurance information (Be sure to bring any insurance documentation, such as plan ID cards, to all of your appointments. Because we often receive insurance plan changes, we may ask you about your insurance at any visit. If your insurance has a co-pay requirement, we will request payment at the time of the visit.)