Patient Registration Forms

Please download, print, and complete the forms below and bring them to your scheduled appointment. If you have questions, please contact the Total Family Healthcare location where your appointment has been scheduled.

Acknowledgement of Privacy Notice
Consent to Release Patient Information
Demographic Sheet
Patient - Provider Agreement
Privacy Notice

Bay City

200 S. Wenona St, Suite 225,
Bay City, MI 48706
p (989) 439-1235
f (989) 439-1238
Hours of Operation:
M 8-5, T 8-5, W 8-5, Th 8-5, F 8-2

Auburn

946 W. Midland Rd, Suite A,
Auburn, MI 48611
p (989) 266-3266
f (989) 266-3269
Hours of Operation:
M 8-5, T 8-5, W 8-5, Th 8-5, F 8-12

Midland

720 W. Wackerly St, Suite 8,
Midland, MI 48640
p (989) 486-9500
f (989) 486-9503
Hours of Operation:
M 8-5, T 8-5, W 8-12, Th 8-5, F 8-4