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Standard forms

We are not accepting new patients at this time.  Please click HERE if you would like to be on our waiting list. 

Anchor 1

Welcome Packet Registration
- Print and fill out -

Please read and complete your Welcome Packet before your first appointment!

Includes:

  • What to bring to your first appointment

  • Financial Policy

  • Patient Registration

  • Contact information

  • Patient-Centered Medical Home information

  • Consent to Care Management

  • Consent to Virtual Appointments

  • Notice of Privacy Practices

  • Authorization for Release of Medical Information  

Personal Contacts

We request that you renew this information every year.  This helps preserve your privacy, and allows us to share your personal health information with those you want to have involved in your health care.

Patient Instructions

225 S M-37, Suite 1 • Hastings, Michigan 49058 • Tel: 269-948-0078 • Fax: 269-948-0099

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