Patient Forms

Filling out paperwork proactively can save you time spent in the office! Once paperwork is complete you can bring it with you to your appointment, or fax it to us prior to your appointment date at (989) 775-3187,

All new patients (If you have not been seen in office in three years or more) please print off the following pages, read and complete. Any forms requiring signatures, please wait to sign in presence of our staff members.

 

Current patients with change in address/telephone/insurance or name, please complete:

This form also needs signed at least yearly for insurance purposes.

 

The following forms are for you to complete if you need records released to us from another office or from us to another office:

Please be specific on what you want released and have your signature witnessed. If bringing the form to our office please have it witnessed by one of our staff members. Allow up to 10 days for these requests to be completed. If urgent, please indicate the nature of urgency and it will be addressed as soon as possible.