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.
 
 
HOME   OUR PRACTICE  SCHEDULE YOUR APPOINTMENT   HOURS & LOCATION   PATIENT REGISTRATION   OUR DOCTORS   EYE EXAMS   CENTER FOR LOW VISION SERVICES   CONTACT LENSES   EYEWEAR   SUNWEAR   EYECARE TECHNOLOGY   LASER VISION CORRECTION   NERWSLETTER   EYE HEALTH NEWS   BLOG    WHAT'S NEW AT DECA   INSURANCE & PAYMENTS   CONTACT US   ORDER CONTACT LENSES   PRIVACY POLICY
 
Dakota Eye Care Associates
Dr. Vogelpohl • Dr. Hennen • Dr. Flockencier • Dr. Zastrow
www.dakeyecare.com
www.facebook.com/dakotaeyecare
1540 Humboldt Ave. Suite 201 • West St. Paul, MN  55118
Phone: 651-457-2020 • Fax: 651-457-0368
Email us at: