105 Northridge Drive New London, WI 54961 | 45 Tenth Street Clintonville, WI 54929
socialmedia_facebook_square_gr_custom New London: 920-982-3711 • Clintonville: 715-823-5112 info@griebenoweyecare.com

Patient Center

What You Need to Know

At Griebenow Eyecare, we believe in continual improvement of our services. Please take a few moments in our patient center and share your experience with our office. We appreciate your feedback!

Patient Satisfaction Survey - Submit Online

Patient Center Online Forms

Speed up your visit by completing the necessary form(s) below. For your convenience, you can either fill the form(s) out online or download and print the form(s) and bring it with you to your appointment.

Patient Health History Form (Required) - Download & Print
Notice of Privacy Practices - Download & Print
Patient Shared Information Form - Download & Print

Payment Options

Griebenow Eyecare has products and pricing to accommodate all budgets for your eye care and eyewear needs, including eyeglasses, contact lenses, routine office visits and medical office visits.

  • Cash
  • Check
  • Visa, MasterCard, and Discover
  • CareCredit

Participating Insurances
We participate with VSP, Medicare, Medicaid, EyeMed, UnitedHealthCare, Network Health, Vision Insurance Plan of America, EyeMed, Blue Cross/Blue Shield, WPS, Humana, Multiplan, HealthEOS, and many others.

Check with our staff if you have other types of coverage.