Forms + Policies

Office Policies

Administration Fee Policy

Well Child Visit Policy

Time of Service-CoPay-Account Balance Policy

Sick Visit Masking Policy

Patient Centered Medical Home Agreement

Controlled Substance Policy

New Patient Forms

Patient Demographics Form

Office and Financial Policy

Medical Records Release

Consent To Treatment of a Minor

HIPPA Compliance Consent

Acknowledgement of Office Policies

Common Forms

Michigan Health Appraisal Form

MHSAA Sports Form

School Medication Authorization Form

Asthma Action Plan