To expedite our communication to you, we request that you fill out the information below. After completing the information you will be granted access to download the Patient Information Questionnaire, including mailing instructions. This form can also be used if you have any questions and/or would like to receive additional information. If you have already had surgery and would like us to review your records, please send your operative reports along with the MRI scans, questionnaire and copy of your insurance card, front and back prior to scheduling your appointment. Information marked with an asterisk (*) must be completed so in the event there is an error with e-mail delivery, we are still able to respond to your question or comment.

The Wisconsin Chiari Center treats patients aged 15 years and older. Parents and guardians of younger patients are advised to contact a neurosurgeon at their local children's hospital.

Please provide the following contact information:

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