Patient Information

Patient Forms

We are happy to provide our office forms for convenient download on your personal computer or device. If you have questions about which forms you need, please call our office and our staff will be happy to assist you.

Please complete the following forms and either email them to contact@westmichiganendocrine.com or fax them to 616.255.9672.

• New Patient Registration Form

• General Consent to Treat Form

• People Involved In Care

• Notice of Privacy Practices

Please review the following forms outlining our policies:

• Office Policy

• Financial Policy

• How to Sign Up for a MyChart Account
  

Referral Instructions

Patients who have never been seen at West Michigan Endocrine, or who were seen by a provider from West Michigan Endocrine over two years ago, will be required to get a referral from their primary care physician.

If you are a current patient of a provider with West Michigan Endocrine and want to be seen at West Michigan Endocrine, please email (contact@westmichiganendocrine.com) or call (616 255-9521) with your date of birth, phone number and approximate date that the appointment should be scheduled. Thank you.

Print the referral form here: Referral Form

Insurance Information

Please contact the office if you have questions about your insurance.