Dexter, MI (734) 426-5220
Patient Login
Schedule Consultation Doctor Only Referral

Patient Forms

man sitting at a wood table, typing on a laptop

Complete Your Patient Form Online Before Your First Visit to Our Office

If you are a new patient, please complete the online form below prior to your first complimentary consultation. The information you provide on this form gives us a better understanding of your previous medical history and your current insurance benefits.

Choose the form you would like to fill out depending on the patient's age range.

Child/Teen Health History Form

Child/Teen Health History Form

Adult Health History Form

Adult Health History Form