FORMS

Convenient Dentistry in La Crosse, WI

Fill out Our Forms Ahead of Time

Below you can download and fill out documents for Coulee Family Dental. If you have any questions or you do not see a document you need, contact us here or call us at 608.782.3102.

Welcome Registration

Medical History

HIPAA Acknowledgement

HIPAA Privacy Notice

Non-Discrimination Policy

Records Release

Can't find what you're looking for? Simply call our friendly staff at 608.782.3102.

Quick Links

Contact Information

Address: 201 7th Street South La Crosse Wisconsin 54601

Phone: 608.782.3102

Fax: (608) 782-3120

Business Hours:

Mon, Tue, Thu: 8:00 am - 5:00 pm
Wednesday: 8:00 am - 6:00 pm
Friday: 8:00 am - 2:00 pm
Sat - Sun: Closed

American Dental Association

Wisconsin Dental Association

Convenient Dentistry in La Crosse, WI

Fill out Our Forms Ahead of Time

Quick Links

Contact Information

Our Location