Your Patient-Centered Medical Home

Medical Forms/Patient Survey

 

Below are links to our medical forms and patient satisfaction survey. For your convenience, you may print them out and complete them at home as needed.

 

New Patients

Our physicians are currently not accepting new patients, however if you use to be established with us but it has been more than 3 years since your last office visit, please fill out the New Patient Application and submit it to the office.

 

New Patient Forms to Update Your Information

If it has been over a year since your last visit or you are a new patient to the office, please use these forms Adult Health History Form, Patient Information Form, Financial Policy and  Notice & Acknowledgment.  Please bring these forms, a photo id, and your insurance information to your appointment.

 

Preparing for Your Visit

Please bring the following items to every visit

  • Current Medications
  • Insurance Card
  • Photo ID
  • List of questions for you to discuss with the doctor
  • Forms that need to be completed at your appointment
  • Diaries (food, blood pressure readings, blood sugar readings ect)

 

Authorization to Release Medical Records

In order to obtain a copy of your medical records or want your records sent to another doctor or facility, please fill out the HIPAA Release Form and turn into the office.  If you want a personal copy of your medical records there will be a charge.  If you need records sent directly to another medical facility, we will send records at no charge. 

 

Authorization to Disclose Information

If you would like the office to disclosure information to someone other than yourself please fill out the Disclosure Authorization form and bring it to the office.  Please click on the link to view our Notice of Privacy Policy.


Location

827 E. Division
Cadillac, MI 49601
MAP


Office Hours

Open 7 Days a Week
Same Day Appointments

Monday: 8:00 am - 8:00 pm
Tuesday: 8:00 am - 8:00 pm
Wednesday: 8:00 am - 8:00 pm
Thursday: 8:00 am - 8:00 pm
Friday: 8:00 am - 8:00 pm
Saturday: 8:00 am - 1:00 pm
Sunday: 8:00 am - Noon


X-Ray Hours

Monday: 8:30 am - 5:00 pm
Tuesday: 8:30 am - 5:00 pm
Wednesday: 8:30 am - 5:00 pm
Thursday: 8:30 am - 5:00 pm
Friday: 8:30 am - 5:00 pm

Closed
1:00 pm - 2:00 pm for Lunch


Lab Hours

Monday: 8:00 am - 4:30 pm
Tuesday: 8:00 am - 4:30 pm
Wednesday: 8:00 am - 4:30 pm
Thursday: 8:00 am - 4:30 pm
Friday: 8:00 am - 4:30 pm

Closed
1:00 pm - 2:00 pm for Lunch


Telephone Directory

Appointments: (231) 775-9741
Billing: (231) 876-3410
Fax: (231) 775-9333


Emergencies

If you have an urgent medical problem after hours or on the weekend, you can reach the on-call physician by calling the answering service at (231) 775-9741. In case of an acute emergency, go to your nearest hospital Emergency Department at once.

News & Updates

July 28, 2017
Family Practice will be closing at 5 p.m on Friday, July 28th, 2017. The office will re-open on Saturday, July 29th at 8 a.m.

MORE NEWS