Forms & Resources
As a part of our mission to provide comprehensive, coordinated healthcare to our patients, we offer several resources to simplify your patient experience.
Billing Inquiries
OakLeaf Clinics Business Office
2403 Folsom St
Eau Claire, WI 54703
715-552-9784
Fax: 715-835-6370
info.businessoffice@oakleafclinics.com
Monday through Friday, 8 AM until 5
Alternatives to In-Person Visits
MyChart, telehealth, and virtual visits are alternatives to an in-person visit and will be submitted to your insurance carrier. We are happy to offer these as alternatives and will continue to make them available moving forward.
- MyChart (patient portal) — An essential tool for communicating with your healthcare team — Connect to your video visits, message clinicians, refill medications, request appointments, complete forms, e-check in, and access your medical records. If you do not have a MyChart account, sign-up online now or call and we will assist you. View MyCart tips for video visits.
- Telehealth (video visits) — Call us or click here to request a telehealth visit with any of our clinicians. Technology is essential and as simple as having MyChart (preferred), FaceTime, Zoom, Skype, etc.
Patient Forms
All Locations
Authorization for Disclosure of Health Information
Authorization for Treatment of a Minor
Medicare Wellness Exam Questionnaire
MyChart - Consent for Proxy Access
MyChart - Mobile App Instructions
MyChart - Video Visits Tip Sheet
New Patient Packet - Pediatric
Notice of Privacy Practices (Spanish)
Patient Financial Responsibility, Assignment of Benefits, and Authorized Representative Agreement
Patient Notice-Protection Against Surprise Billing
Written Acknowledgement of Receipt
OakLeaf Pediatrics
NICHQ Vanderbilt Assessment - Parent
NICHQ Vanderbilt Assessment - Teacher
NICHQ Vanderbilt Follow-Up - Parent