Welcome to MidwestRetina!  As a new patient you will be required to fill out paper work upon your arrival.  In order to expedite your first visit, we ask that you print out the Medical History Questionnaire Form and the Patient Financial Policy Form below and arrive with it completed. 
For more information regarding your first visit please see Visit Information.

Current Midwest Retina Patients: The Amsler Grid Form is the only form we have available for download to current patients.  This form can be downloaded below.  If you are looking for information regarding your diagnosis please see Eye Anatomy/Diseases.

Forms: All forms open in an Adobe PDF file.