DO NOT SUBMIT THIS PACKET VIA EMAIL
We are unable to accept patient information via email, but you are encouraged to print this document and bring it in at the time of your appointment.
All NEW patients are required to fill out this paperwork for their first visit.
You can have this prepared prior to your visit or arrive 30 minutes early to complete it on the day of your apppointment.
Dr. Richard H. Wingert, MD 1003 Del Prado S. Unit 101 Cape Coral, FL 33990 (239) 574-4600 Conveniently Located in the Tower’s Building right next to Mr. Carwash