New Patients

Above are the new patient forms that will be required at the time of your appointment. You may print and fill these out in order to reduce the wait time.

MyChart: We encourage all of our patients to be involved in their medical care by viewing their electronic medical record through Henry Ford MyChart. To obtain access before your first appointment please call 1-800-HENRYFORD to get your medical record number and ensure your contact information is up to date. Then complete the form at

To prepare for your visit to our office please read the following:

We are REQUIRED to obtain a copy of your state identification card and insurance card at EVERY VISIT to be in compliance with HIPPA, state and federal regulations. We are unable to see you without this information. We also need to obtain a copy of your prescription drug card if it is separate from your insurance card. We cannot get approvals and renewals for your medications without this information.

As electronic medical records are used by various physicians throughout different hospitals it is essential that you verify your medication list BEFORE EVERY VISIT. Even if you do not believe anything has changed, the information in your chart may have been inaccurately updated by another facility without your knowledge. For this reason, we are required to have you review and update your medication list every time you come in.

Medication lists can be reviewed ahead of time on Henry Ford MyChart. Log in to MyChart and click the “view your health summary” icon. If you find an error, click “submit an update to this list” or you can notify us at the time of your visit and we can make the correction for you, as we will have a copy of this list.

If you are unable to review your medication list ahead of time on MyChart, please try to arrive 10-15 minutes before your appointment with a copy of all your current medications to allow yourself time to verify your list before being seen. We appreciate your cooperation in this very important process.