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Standard forms

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 will ask you to update this important privacy information every year.  This informs our practice of who you wish to allow access to your health data.

 

If your health contacts change at any time, print this form and bring it to the office with your updated contacts.

Patient Instructions

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

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