Patient forms

Your paperwork, done before you arrive.

Fill out your new-patient forms online ahead of time, so your first visit starts in the chair, not the waiting room. Everything is submitted securely, and it works just as well on your phone.

Questions? Call 810-987-8310

Recommended for new patients

The new-patient packet

Everything for your first visit in one secure session: registration, medical & dental history, the privacy acknowledgement, and the financial agreement. It takes about 10–15 minutes, and you can finish it from your phone.

Open the packet

Or complete a single form

Already registered, or only need one document? Each form opens on its own.

Registration form

Your contact details, insurance, and emergency contact. (opens in a new tab)
Medical history form

Conditions, medications, and allergies, so we can care for you safely. (opens in a new tab)
Dental history form

Your past dental care, concerns, and what brings you in. (opens in a new tab)
HIPAA Notice of Privacy Practices

How we protect and handle your health information. (opens in a new tab)
Financial agreement form

Our billing and payment policies, so there are no surprises. (opens in a new tab)

Your information goes straight into our secure patient portal, the same system we use in the office. Each form opens in a new tab.

Prefer to fill things out in person? That's completely fine. Call 810-987-8310 and we'll have everything ready when you arrive.

Your paperwork, done before you arrive.

The new-patient packet

Or complete a single form

Registration form

Medical history form

Dental history form

HIPAA Notice of Privacy Practices

Financial agreement form