Request an Appointment Making the most of your first appointment. First NameLast NameDate of Birth Date Format: MM slash DD slash YYYY 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.