new and existing patient paperwork

Patient Forms

If patients can complete the instructed New Patient Paperwork and bring it with them at their initial consultation and evaluation, it would be greatly appreciated.

View Forms

Download Forms

Forms are in the PDF format. You will need PDF software on your computer, although most modern computers sold in the last 10 years come with PDF software out of the box. If yours didn’t, download Adobe Acrobat Reader here.

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New Patient Forms

Insurance and Billing Policies

We do accept insurance.
a. BCBS of Michigan
b. BCBS PPO
c. Blue Care Network
d. Medicare
e. Medicaid
f. Aetna
g. Farmers Insurance
h. Health Alliance Plan (HAP)
i. United Healthcare
j. Benefits Service Group
k. Mcare
l. Cigna
m. Citizens
n. Priority Health Plan
o. Employee Health
p. Frankenmuth
q. Meridian Health Plan

All materials on this website including but not limited to text, copy, images and photographs are provided for informational purposes only. This website and related materials are not intended to be a substitute for professional health advice, diagnosis, or treatment.

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(248) 656-2273

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drhamilton@nullmainstreetcc.com

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145 S. Rochdale Suite A & B, Rochester Hills, MI 48309

145 S. Rochdale Suite A & B
Rochester Hills, MI 48309

Tel: (248) 656-2273