Office Forms

Complete your Medical Forms in Advance

When you visit us for the first time, we must ask you to fill out some forms. In order to reduce your registration time, we have made these forms available online so that you can complete then and bring them with you to your appointment.

Explanation of forms:

New Patient Form – Click here to download form

Page one: Basic Demographic information

Page two: By signing at designated areas allows us to bill your insurance and if desired release information to specific family members of your choice

Page three: Consent to treat you

Page four: Release to obtain medical records from your previous doctor if necessary

Page five: HIPPA – Protection of your medical record

Sports Physical form – Click here to download form

This is the Michigan High School Athletic Association Form required by the State of Michigan to participate in school activities and sports. If your child is coming in today for a well check or sports physical, you can download this form ahead of time to reduce your registration time.

Please fill out the top demographics, the medical history section, and the entire second page before arriving to your appointment.

Health Appraisal Form for Preschool – Click here to download form

Durable Power of Attorney  – Click here to download form

Panthers Form  – Click here to download form

Patient Survey  – Click here to download form

DOWNLOAD INSTRUCTIONS:

To download a medical form:

1. Click on the link for the form you wish to download
2. The form will display in a new window
3. From the menu bar at the top of the page, click on
   File >> Save As
4. Navigate to the place on your computer where you want to save the form
5. Click Save