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71 E. Long Lake Rd.

Bloomfield Hills, MI 48304

(248)-533-0000

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  • Home

  • About Us

  • Forms, Policies & Resources

    • General Health
    • Immunizations
    • Insurance, Self-Pay Fees & Billing
    • Office Policies
    • Office Forms
    • New Patient Registration

  • Our Team

    • Meet Our Clinicians
    • Meet Our RN & Front Desk Team

  • Contact Us

  • Patient Portal

  • After Hours Resources

  • More

    Use tab to navigate through the menu items.

    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
    Mask Exemption Request Form* - Established Patients ONLY
    SARS Antigen Testing- Fact Sheet for Patients
    Patient Portal & Healow App Instructions
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    * Please use this contact form for general office inquiries only. For any patient-related or  medical questions or concerns, please contact our office by phone at (248)-533-0000 or send us a message through the patient portal.