We are so glad you have chosen us to be your healthcare provider. Follow these easy steps to experience the very best first visit at our practice:

Step 1: Print and complete the patient forms located below
Step 2: Simply call our office at 586-286-9720
Step 3: Print directions

New patient forms

• Child history form
• Adult history form
• Adult registration form
• Child registration form
• Cancellation and refill policy form
• New patient prescription form
• Notice of privacy practices

When you call our office to schedule your new appointment, we will ask for basic demographic information as well as insurance, and enter it into our electronic medical records system.

On the day of your visit, we will scan a copy of your picture identification and insurance card into our electronic medical records system. Your co-payment, coinsurance and/or deductible will be collected on the day of your visit. Our computer system is linked with the insurance carrier fee schedules, so we are able to determine patient responsibility on the day of your visit. Our office accepts cash, check, American Express, Discover, MasterCard or Visa.

Electronic Medical Record information

Our office has implemented an electronic medical records system to allow us to provide the following benefits to our patients:

• Continuity of care – Your chart will always be up-to date, legible and accessible.
• Privacy – Your personal health information is accessible only to authorized individuals within our office, and all computers are password protected.
• Timesaving – Your prescriptions will be sent electronically to your pharmacy, when available.
• Safety – Our system allows us to get alerts to avoid allergies and drug interactions.
• Improved outcomes – Built-in prompts such as up-to-date disease management plans, follow up labs or imaging studies and preventive health service reminders help us manage your care.

HIPAA/Patient Privacy
Please be sure to read and sign our Patient Privacy Policies and bring to your first appointment. The form is located on this page under the heading “New patient forms.”

Individuals may complain to FFPC and to the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated.