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We have included several of the papers that need to be completed before you see Dr. Stachniw that might make your stay in the waiting room just a little bit shorter! Make sure to bring your papers with you, or mail them to the office before your next appointment. If you remember, tell the receptionist that you received the papers through this website.
Each link is a PDF so that you can print them easily, however they require you to have Adobe Acrobat (or a similar program to view). If you don't have Acrobat on your computer, click here to download the program. It's really easy!
Once you have Acrobat Reader, download a document by clicking on an icon at right.
Remember: some of the forms are for your own files and some are to be brought back to the office!
If you are planning on mailing your forms back, please send to:
Midwest Orthopedic Services, sc.
834 N. Seminary St. Suite #406
Galesburg, IL 61401
(309) 341-1300
Fax: (309) 341-1377
New Patient Authorization
New Patient Information Sheet
Forms to be completed and returned to office:
Forms for you to keep for your own records:
Resurfacing Insurance Information
New Patient Credit Policy Information
