ReforMedicine Appointment Request Form

*Submitting your request via this online form does not guarantee available appointment times. If your matter is urgent, please call the office at 715-514-2827.

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  • WARNING: This contact form does NOT send encrypted, secured messages. This is merely a messaging tool. For your own protection, PLEASE DO NOT, under any circumstances use the message block below to provide personal protected health information or private details of any kind. Any health information or confidential information should be transmitted through the secured patient portal. You may always call ReforMedicine at 715.514-2827. Thank you!