For your convenience, we are pleased to provide these fillable PDF patient forms for you to download prior to your appointment. Please open the form, fill it in, and then print it out. Please bring the completed forms with you to your appointment or you can fax the forms to 586-286-3619. Please do not e-mail them to us, since e-mail is unsuitable for secure communications.

Assignment of Insurance Benefits (PDF)

Confidential Communications Preference (PDF)

Patient Medical (2 page PDF)

Patient Registration Form

Patient Social History (PDF)

Patient Financial Policy

The American Academy of Ophthalmology Michigan Society of Eye Physicians & Surgeons American Medical Association American Academy of Cosmetic Surgery ASOPRS Michigan State Medical Society