New Patient Forms

<p><a href="/storage/app/media/general_patient_form.pdf" target="_blank"><img src="/storage/app/media/download.jpg" data-image="mediaManagerImagedownload.jpg" alt="Download Form" class="align-none"></a></p>

Prepare for your appointment:

  • Download the necessary form(s) below, 
  • E-mail/Fax us your completed forms at  i[email protected] or (810) 820-2134
  • Bring your completed form, insurance card (s) and Driver's license with you to your appointment.
  • Arrive 15-20 minutes prior to your appointment.

New Patient Health History Form - Chiropractic


Download Form


New Patient Health History Form - Functional Medicine/Nutrition

Download Form


Request Appointment

Locations

--mi

Holistic Health Center

Address

2065 S. Center Rd
Burton, MI 48519

Contact Information (810) 337-9594

(810) 835-4595