Patient Forms & Information

Save Time
Be Ready

Streamline Your Experience

We understand the importance of convenience and ease when it comes to your health and wellness. With our user-friendly online forms, you can save time and effort by completing necessary paperwork before your appointment.

  • Choose your service area, print, and fill out the forms before your visit.
  • Be sure to bring the completed forms to your appointment.

Save Time
Be Ready

Streamline Your Experience

We understand the importance of convenience and ease when it comes to your health and wellness. With our user-friendly online forms, you can save time and effort by completing necessary paperwork before your appointment.

  • Choose your service area, print, and fill out the forms before your visit.
  • Be sure to bring the completed forms to your appointment.

Patient
Portal

Consent
Form

COVID-19
Form

HIPAA
Form

Insurance
Information

Intake
Form

Patient Introduction

COVID-19
Form

HIPAA
Form

Insurance
Information

Patient
Introduction

X-Ray
Consent

HIPAA
Form

Patient
Introduction

PIP
Application

PIP Assignment
of Benefits

X-Ray
Consent

Client
Form

COVID-19
Form

Client
Form

COVID-19
Form

Insurance
Information

X-Ray
Consent

COVID-19
Form

HIPAA
Form

Insurance
Information

Patient
Introduction

Physical Therapy
Form

HIPAA
Form

Patient
Introduction

PIP
Application

PIP Assignment
of Benefits

COVID-19
Form

HIPAA
Form

Insurance
Information

Patient
Introduction

Occupational Therapy
Form

Ready to Start
Feeling Better?

Take charge of your health and experience the Eastpointe Integrated Healthcare difference. Schedule an appointment today and embark on a journey toward optimal well-being!

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