Make a Request
If you are a current patient, we’re happy to assist you with certain simple, non-urgent requests. Please complete the applicable form below and someone from our office will be in contact with you in 24-48 hours.
If you need to schedule an appointment, please call the office. If this is a medical emergency, please call 911.
Prescription Refill Request
Please click the button below to begin your secure prescription request.
Do you need medical records or a form completed for school/daycare?
Please email the form to records@tosapediatrics.com and it will be completed and returned to you within 24 business hours. Note: Most times our return email will go to your junk/spam folder.
Vaccines Records Request
To gain ongoing access to your child’s records on Wisconsin Immunization Registry, please complete this form:
Don’t have access to your child’s SSN? Please complete the form below to contact our office.