New Patient Forms
Please download and BRING the applicable forms to your first appointment. If you choose to complete the paperwork at the clinic you may arrive for your appointment 30 minutes before your scheduled appointment time. If you have any questions, do not hesitate to call our office staff at (734) 453-5603. Thank you.
Please bring a picture ID and your insurance/HMO card. Ensure all forms are complete and with signatures. You may give your completed forms to office staff or your clinician (after hours).
Please complete the Adult Personal History Questionnaire (age 18+) or Child/Adolescent Personal History Questionnaire - whichever questionnaire applies to you.
Custody Situations
(as applicable)
Joint legal custody is defined as both parents' ability to make all major decisions regarding their children. When considering a minor child for treatment, joint legal custody requires both parents' signature on the Consent to Treatment form. Sole legal custody requires court documents stating the custody arrangement. Please consult legal advice if you need further information.