Please note, we are unfortunately unable to enroll any new patients,

at this time, but are placing new potential patients on a waitlist.

Please contact our office for further details. 

For New Patients:


To register as a new patient to the practice, please complete the new patient registration below. The forms may also be obtained at our office to be completed before your first scheduled appointment. You may mail, fax, or e-mail completed forms to our office before your first appointment. Please also bring all current medications to your initial appointment. 

If you would like to schedule a meeting to determine if our practice is the right fit for you, please contact us at (269) 429-5000 or  

Welcome to the practice!

Forms for New Patients

Below are a few forms that you can download, print and fill out to bring in to us so you don't have to fill them out in the waiting room. Note: you can email them to us, but our email server is not secure or encrypted and not HIPAA compliant.

Adult Health

History Form

Pediatric Health

History Form

Telephone Consent


Patient Info Sheet

New Privacy Notice


Once you have signed up, you may want to download, fill out and email back our Patient Agreement Form. If not, you may complete it at the office upon your next visit.