Dakota Eye Care Associates
 
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Patient Registration

 
Save time - complete registration in advance . . .

You may save time in our office on the day of your appointment by printing and completing the Registration Forms. There are 2 forms ( 3 pages ) to be completed:
  1. Patient Financial Information (download PDF file)
  2. Personal Medical History (download PDF file)

Submitting your Patient Registration

Due to the secure information requested, please do not email the completed forms.

To submit the completed forms:

  • bring the forms with you to your appointment
  • mail the forms to our office*

Dakota Eye Care Associates
1540 Humboldt Avenue, Suite 201
West St. Paul, MN  55118

* If returning forms by mail, please postmark at least 3 days prior to your appointment to ensure ample delivery time.

 
 
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Dakota Eye Care Associates
Dr. Vogelpohl Dr. Hennen Dr. Flockencier Dr. Zastrow
www.dakeyecare.com
1540 Humboldt Ave. Suite 201 West St. Paul, MN  55118
Phone: 651-457-2020 Fax: 651-457-0368