203 S. Zeeb Rd Suite 106 Ann Arbor, MI 48103 | 734-274-5107

Reactivation Forms

Home/Reactivation Forms

Online Reactivation Forms

To expedite the re-activation process, we encourage you to fill out your forms before your appointment. To ensure that patients are receiving the best care possible, patients who have not been seen for 90 days or more are required to complete re-activation forms prior to resuming care.

Reactivation Adult Form

Reactivation Pediatric Form