The office will close at 2pm Friday 5/22/20

6000 24 Mile Road, Shelby Township, Michigan 48316

Appointments: 586-884-6702

Appointments: 586-884-6702

Home
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Home
About Us
Our Providers
Forms

Partners in Family Medicine

Your Patient Centered Medical Home

Your Patient Centered Medical HomeYour Patient Centered Medical Home

Releases

Medical Records release from Previous Provider (pdf)Download

Release of Information for prescriptions (pdf)Download

Medical Records release to another Provider from PFM (pdf)Download

HIPAA Privacy Notice

HIPAA Notice (pdf)Download

New patient forms

Print and complete these 6 forms along with a list of current medications and bring them with you to your first appointment.

Patient Demographic form (docx)Download

Patient consent (docx)Download

PCMH Agreement (pdf)Download

Release of Information (pdf)Download

Office Policies for patients (docx)Download

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