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Patient Forms

Save Time On Your First Visit

* New Patients *

Please prepare and print the two-page form and bring it to your first visit.
(Instructions Below)

New Patient Form: Download Here

Document Preview
New_Patient_Form.jpg

To Complete in Adobe Acrobat:
  1. Download file
  2. Fill out in Adobe Acrobat
  3. Print
To Complete in Browser:
  1. Click file to open in browser
  2. Fill out in browser
  3. Print
To Complete Manually:
  1. Download file
  2. Print
  3. Fill out by hand

(Optional) - Upload your completed form below

If you don't have a printer or would like to save time, you can upload your completed forms by uploading them below:

  • Home
  • Meet Our Physicians
  • Accepted Insurances
  • Patient Forms
  • Conditions We Treat
  • Contact & Map

Phone
(248) 844-0200

Fax
(248) 844-0219

Address
Endocrine & Diabetes Consultants

2970 Crooks Road, Suite A
Rochester Hills, Michigan 48309

Hours of Operation
Monday - Thursday | 9am - 5pm
Friday | 9am - 12:30pm
Saturday - Sunday | Closed

Phone Hours
Monday - Thursday | 9am - 4pm
Friday | 9am - 12:30pm

Learning Resources:
National & International Endocrine Resources

  • Endocrine Society
  • American Society for Bone and Mineral Research
  • American Diabetes Association
  • American Thyroid Association
  • American Association for Clinical Endocrinologists (AACE)

Diabetes Resources

  • Department of Community Health @ Michigan.gov - Diabetes Management & Prevention
  • Diabetes Fact Sheet (2006)
  • Diabetes Statistics
  • Diabetes Leading Cause of Mortality (2004)
  • Diabetes-Related Hospital Discharge and Amputation (2004)

Obesity & Overweight Resources

  • National Weight Control Registry
  • Overweight and Obesity in the USA
  • Weight Control Statistics - NIH USA

Osteoporosis Resources

  • National Osteoporosis Foundation
  • NIAMS / NIH - Osteoporosis & Related Bone Diseases