Request an Appointment Making the most of your first appointment. First NameLast NameDate of Birth PhoneEmailReferring Physician (If Applicable)Referring Practice (If Applicable)Name of Insurance CompanyHow Did You Hear of Us?Online SearchSocial MediaPhysician ReferralPrint AdNewsFriend/FamilyHow Can We Help? Please Bring the Following Items to Your Appointment X-Rays, Test Results, & Medications Pre-Registration Forms (Access here) Insurance Card We listen and we empathize. Contact Us Contact 4600 W. Loomis Rd Suite 101Greenfield, WI 53220Phone: (414) 488-1818Fax: (414) 763-4116 Office Hours Monday - Friday:8 a.m. to 5 p.m.Closed weekends and holidays Copyright © 2019 Shekhar A. Dagam, MD Neurosurgery. All rights reserved.