PATIENT FORMS

Thank you for visiting the Friedman Surgical Group.

To expedite your visit – please read, download, (fill as noted,) print, and sign the following forms. Please bring the forms to our office or fax them to 1-734-462-1830. If you have any questions please contact our main office at 1-734-462-1525.

The Friedman Surgical Group accepts most major medical insurances. Please bring your medical card upon your visit, or call our main office to confirm coverage.

Patient Intake Form Page 1 – Please print, fill, and bring to office.
Patient Intake Form Page 2 – Please print, fill, and sign at office.
Patient HIPAA Consent Form Part 1 – Please print, fill, and sign at office.
Patient HIPAA Consent Form Part 2 – Please print, fill, and sign at office.
Disability Paperwork Processing Fees Notice– Please print, fill, and sign at office.

Thank You!
Friedman Surgical Group

All forms revised 08/15/2024

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