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.

Friedman Surgical Group Patient Forms are printable (and fillable as noted) in Adobe Acrobat Reader (PDF format).

Patient Intake Form Page 1 – Please print and bring to office.
Patient Intake Form Page 2 – Please print and bring to office.
Patient HIPAA Consent Form Part 1 – Please print and sign at office.
Patient HIPAA Consent Form Part 2– Please print and sign at office.
COVID19 Agreement – Please print and sign at office.

Thank You!
Friedman Surgical Group

All forms revised 04/30/2020

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