Patient Documents

Please print and complete the following forms prior to your appointment. If you have any questions, don’t hesitate to call the office at (248) 710-0063 or email us at

BC BS Signature on File

Bill of Rights – Payment – Medicare

Capstone Privacy & Communication

Health History

Patient Information

Patient Rights & Responsibilities

The following document explains directions for ONLINE Telemedicine Appointments. Please read and follow the directions.  Don’t forget! We are here to help if you have any questions, or are unsure about anything.

Direction for Telemedicine