Patient forms and documents

There are several documents Prevea patients can request and fill out, even before scheduling an appointment with our providers. Whether you’re trying to obtain medical records prior to an upcoming appointment, access behavioral care forms before meeting your physician, or fill out advance directive’s paperwork used to identify a person of your choice to make health care decisions on your behalf; Prevea has you covered online.

Prevea patients can also learn more about how to schedule video/phone visits with doctors, information related to who qualifies for family medical leave assistance and how a My Prevea account can help patients pay a bill, request a price estimate and view medical history.

Advance directives

Prevea wants you to know you have the right to make decisions about your health care. You can do this by completing an Advance Directive.

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Patient care forms

If you or a loved one has an upcoming appointment at Prevea, we ask you download and complete these forms prior to your visit.

Download and complete

Video visit instructions

Select departments are offering video and group video visits. If you've been scheduled for a video visit, click here to download the instructions how to access your appointment.

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Family Medical Leave Assistance (FMLA)

Your right to know. The Family and Medical Leave Act (FMLA) provides a means for eligible employees to balance their work and family responsibilities by taking unpaid, job-protected leave for specified reasons.

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Medical records authorization form

Whether you're switching to Prevea or requesting a copy of your medical records, download and complete the medical release form and submit this to Prevea's record release department.

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MyPrevea

Looking for a place to request a price estimate, pay a bill, view your medical history, and more? By registering for a MyPrevea account, you have access to your health at your finger tips.

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Power of Attorney

Form used for Power of Attorney Delegating Parental Power for Eastern Wisconsin. Please bring this along to your appointment.

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Notice of privacy practices

These notices describe how medical information about you may be used and disclosed, and how you get access to this information.

Click to download

HIPAA consent forms

As the patient, I understand that I am the primary person to receive information from physicians and other caregivers regarding my health condition, treatment and progress.

Click to download

Your health and privacy matters

If you have a question or concerns and would like to speak with someone directly. Please fill out the contact form on the next page, or connect with us by calling our office.