Patient Portal       42755 Mound Rd. Sterling Heights, MI 48314

New Patient Information

New Patient Information

We are excited for you to join our family


Forms:

When you visit us for the first time, we must ask you to fill out some forms. In order to reduce your registration time, we have made these forms available by following the simple steps below. You can fill the out in the comfort of your home and bring them with you to your appointment.

In addition, you will need to bring your insurance cards and photo identification.

General Patient Information Form

Patient Medication Record

Health History Form - 1

Health History Form - 2

If needed, please download Adobe Acrobat below to view/print forms: Download Adobe Reader

Payment Options:

Our fees are consistent with those in the surrounding community, and we accept most insurance plans. Payment is expected at the time of service. For your convenience, we accept VISA, Mastercard, Novus/Discover, debit cards and personal checks. Our staff will be happy to answer your questions regarding insurance billing.

Insurance We Accept:

Blue Cross/Blue Shield
Blue Care Network
St. John Smart Health
Most Commercial Carriers
Medicare
Medicaid
Medicaid HMO Plans (we currently only accept Meridian, United HealthCare Community Plan, and Aetna Better Health)
For questions regarding a specific insurance carrier, please contact our office for assistance.

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