Office Forms | Serenity Pediatrics

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71 E. Long Lake Rd.

Bloomfield Hills, MI 48304

(248)-533-0000

OFFICE FORMS

Patient Centered Medical Home

Health Appraisal

Medical Records Release

New Patient History Form

Newborn History Form

Third Party Consent for Treatment & Examination

Authorization to Share PHI

Michigan Sports Physical Form

Patient Rights & Responsibilities

Patient Portal Access