(248) 539-4800
Select Page

New Patient Form

We are happy to provide you with HIPAA-secure web form that you can fill out right on your computer. No printing or hand writing necessary! Simply click on the link below and a new browser window will open with the form. Fill it out right on your computer and hit the “submit” button at the bottom of the form. We will receive your form through our HIPAA-secure email and have it ready to go before you arrive for your appointment. Its that easy!

BVC PATIENT/DEVELOPMENT QUESTIONNAIRE

Here is a link to a print version of the form. If you prefer you can print it, fill it out and bring it to the office.

Patient Development Questionnaire (print version)

Here is a link to the PDF of our new HIPAA financial policy form. You can print this, sign it and bring it in to the office.

HIPAA Financial Policy Form