Patient Forms
If you are a new patient please download and complete the following forms. By downloading these forms and completing them, it will save you time when registering for your first appointment. Thank you.
- Patient Registration Form
- Health History Questionnaire
- Privacy Policy, for you to keep
- Consent to Use and Disclose Protected Health Information
- Patient-Centered Medical Home (PCMH) for you to keep
- Informed consent-for preventative medicine visit (complete physical)
- Your health insurance cards (if you have more than one card, please bring all applicable cards)
- Your driver license
- The forms that you have download and completed
Debbie Pelker
Office Manager
248-625-1600 Ext 235