Helpful Forms

Click on the following to download:

Intake

PDF

Consent Form

PDF

Emergency Contact Info

PDF

Information Exchange Authorization

School

PDF

Primary Care Physician

PDF

Generic

PDF

Grand Rapids Office:

5242 Plainfield Ave NE
Suite A
Grand Rapids, MI 49525

616.363.2200
fax: 616.363.5337
Email Our Office

Midland Office:

4604 North Saginaw Road
(2nd level @ east end of building)
Midland, MI 48640

For appointments:
616-363-2200
Email Our Office