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Legacy Family Medicine, P.C.
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Patient Forms

Home / Patient Forms

Downloadable patient forms

Select a form to download and mail, fax, or bring it into the office as necessary.

Adult Patient History Forms.pdf (1mb)
Adult Patient Registration Form.pdf (1mb)
Child and Adolescent History Form.pdf (245kb)
Child and Adolescent Registration Forms.pdf (904kb)
Confidential Communications.pdf (22kb)
Consent for treatment-Financial Authorization.pdf (70kb) 

ABOUT US

  • Board Certified Family Medicine physicians.
  • Assistant Professors at Oakland University William Beaumont School of Medicine.
  • Clinical Assistant Professors at Michigan State College of Osteopathic Medicine.
  • Evening and weekend hours for your convenience.

RECENT POSTS

  • STAYING UP ON COVID-19: WHAT OUR OFFICE IS DOING TO STAY OPEN FOR YOU April 3, 2020
  • How Much Should You Exercise? New Guidelines Give Recommendations. November 28, 2018
  • Flu Season is Upon Us January 11, 2017

Contact

Legacy Family Medicine, P.C.
35429 Schoenherr Rd.
Sterling Heights, MI 48312

Phone: (586) 274-1145

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Information provided on Legacyfamilydocs.com, or from links provided on our website, is not intended to provide medical advice. Information on this website is not a substitute for professional medical advice. Use of this site does not establish a doctor patient relationship. To diagnose or treat a health problem, for questions regarding a medical condition, or prior to starting any new treatment, you should consult with a qualified healthcare provider.

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  • Home
  • The Doctors/About Us
  • Patient Services
  • Medical/Practice News
  • Patient Forms
  • Reviews
  • Contact/Location