Patient Forms

REGISTRATION

 

The following patient registration forms need to be filled out for your consultation or if you have not been seen within the past year. Please download, print and fill-out these forms. Please bring the completed and signed forms to your appointment along with:

 

  • Your insurance card(s)

  • Driver license

  • Medication list

  • And any pertinent records that you have

 

Failure to bring any of these items may result in rescheduling of your appointment.

 

When visiting our office for the first time please arrive at least 20 minutes early.

NOTICE OF PRIVACY PRACTICES

 

This notice describes how health information about you may be used and disclosed and how you can get access to this information.

 

Please review it carefully. 

 

 

If you have any questions about this notice, please contact our office by dialing (810) 733-8400.

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Grand Blanc Surgical Specialist

8384 Holly Road - Suite 1

Grand Blanc, MI 48439

(810) 733-8400