262-522-3070

Pewaukee, Mukwonago & Delafield

Neurological Wellness Clinic, Pewaukee WI

Patient Forms

New Patient at Neurological Wellness Clinic

New Patients

Welcome to the Neurological Wellness Clinic! We've tried to make the process of becoming a new patient as simple as possible. Please download the New Patient Packet, print and complete the forms prior to your appointment. The New Patient Packet contains:

  • Welcome Letter
  • Patient's Contact Authorization
  • Insurance and Financial Policy
  • Health History Forms
Sleep Study Test at Neurology Wellness Clinic

Procedure Forms

The following forms are for procedures. If you're having any of the listed procedures, please download the form(s), print and complete before your next appointment or procedure. Thank you!

Neurological Wellness Clinics map

Neurological Wellness Clinics

Pewaukee OfficePewaukee Office

2347 Silvernail Road
Pewaukee, WI 53072

Delafield OfficeDelafield Office

ProHealth Care Sleep Center
Purity Building at I-94 & Hwy 83
2301 Sun Valley Drive
Delafield, WI 53018

Sleep Issues, Sleep Studies

Mukwonago OfficeMukwonago Office

ProHealth Care Medical Center
D.N. Greenwald Center
240 W. Maple Avenue
Mukwonago, WI 53149