CONTACTS

STAFF
Brian Kiesnowski, MD, MPH
Meredith Kiesnowski, MHA, FACMPE, FACHE- Administrator

Jenny Cappaert - Front Desk Manager

ADDRESS 
5605 Waterford Lane
Appleton, WI 54913
Phone: 920.738.7200
Toll Free: 800.801.3101
Fax: 920.273.2500

OFFICE HOURS:

Monday 8:00 am - 4:00 pm
Tuesday 8:00 am - 5:00 pm
Wednesday 8:00 am - 3:00 pm
Thursday 8:00 am - 5:00 pm
Friday

8:00 am - 12:00 pm

PreRegistration Form.pdf
Adobe Acrobat document [575.7 KB]

Pre-Registration
After filling out form, save to desktop with a new file name. Click kiesnowski@gmail.com link to create email. Drag newly named PDF from desktop to email as an attachment. Click Send. NOTE: When patients send their registration forms via email, that the email is NOT encrypted and that personal information may be compromised.  The patient assumes risk for disclosure of private information for forms emailed to the office.  For maximum safety, patients should print out, then fax registration forms to the office!  You can also bring your paperwork with you to your consultation.

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Contact Us Today!

APPLETON PLASTIC SURGERY CENTER, SC
5605 Waterford Lane

Appleton, WI 54913

AND

1405 Mill Street

New London, WI  54961

(Inside ThedaCare Medical Center - New London)

 

Phone:  920.738.7200

                    or          

             800.801.3101

 

Fax:     920.273.2500

 

E-mail: kiesnowski@gmail.com

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