Good Problems to Have

Due to a recent influx of new patients we are temporarily pausing new signups. Please complete the form below to be added to our waitlist. We will contact you to schedule a Discovery Call with Dr. Mirer when we resume.

Join our Waitlist
Patient First Name
Patient Last Name
Patient Pronouns
Patient Age Group
Are you inquiring about gender-affirming care?
Parent/Guardian 1 First Name
Parent/Guardian 1 Last Name
Parent/Guardian 1 Pronouns
Parent/Guardian 2 First Name
Parent/Guardian 2 Last Name
Parent/Guardian 2 Pronouns
Email
Phone
Email 2
Phone 2
How soon does the patient need to be seen?
Has Dr. Mirer been your/their doctor before?
Please acknowledge that you understand that Dr. Mirer can only treat patients in Wisconsin.
What else should we know?