Forms
 

If you are a new patient or if we haven't seen you in three years, please fill out Patient Info form and the Medical History Questionnaire. If you are an established patient and we have seen you within the past three years, fill out the Patient Info form only. The HIPAA form should be filled out in addition to the other forms, if you are a new patient to the office.

Click on a form, click print and then click the back button on your browser. Fill it out at your convenience and bring it with you to your appointment.


Our Locations
 
Paige Fleckenstein, O.D.
Tracie Malsom, O.D.
Daniel Wendorff, O.D.

Dr. Daniel Wendorff & Associates
1251 US 31 North
Greenwood, IN
Driving Directions

Phone: 317-887-2732

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