Medical intake
Four sections to help us prepare for your care.
Fill, print and bring to your visit. Online submission is not available yet. Typing here does not send your information to the office. Print or save a copy before leaving this page.
Download fillable medical intake PDF
List what you know. Write “none” or “not sure” if needed. Attach an extra page or medication list.
Registration and office documents
- Patient registration (PDF)
- Office and financial policies (PDF)
- Your patient-centered medical home (PDF)
Bring your insurance card(s), photo ID and medication list. Our team can help with registration, privacy notices and policy signatures at check-in.
Need help? Call 248-288-9300.