Our staff welcomes you!


map to Fox Valley Wellness

Map to Fox Valley Wellness Center

New Patients

New Patient Form

Prospective new patients must complete the New Patient Form and return before scheduling with Fox Valley Wellness/Midwest Hyperbarics. You may print the PDF, complete, and mail to us or you may download the Word document, complete, save to your computer, and email to us as an attachment. Instructions are listed on the form.    PDF       Word

New Patient Packet

New patients receive the following files after your appointment is scheduled. All completed files must be returned to us prior to your first visit.

What to Expect on Your First Visit
Welcome Letter
Directions to FVWC
Patient Registration
Authorization for Disclosure (HIPPA)
Patient Responsibility & Compliance
FVWC Policies & Protocols
New Patient Supplement & Medicine Sheet
Lifestyle History
Medical History
Yeast Questionnaire
Symptom Questionnaire
Lyme Informed Consent
Lyme Questionnaire
Full New Patient Packet


Our staff welcomes you!