No Appointment Necessary

Patient Forms

If you are a new patient to Midwest Convenient Care or have not been seen in the clinic greater than 12 months, please feel free to print and complete any of the following forms applicable to your visit to ensure that your visit is as swift as possible. Arriving with all necessary paperwork greatly assists our staff in creating and updating your file while limiting your overall wait time.

New Patient Information

If you need to have a copy of a visit at Midwest Convenient Care sent to another entity, please print and complete the form.

Medical Release Form

If you will be coming to Midwest Convenient Care as a Workman's Compensation visit, to ensure that your visit is as swift as possible, please feel free to print and complete the paperwork prior to your visit. Arriving with all the necessary paperwork greatly assists our staff in creating your Worker Compensation file while limiting your overall wait time.

Worker Compensation​

If you have any questions about the forms, please use the contact link within the webpage or call the clinic for more information. We look forward to serving you!