Patient Forms


 

The following forms are available for download.  The forms on the right side of the page are also available on the Patient Portal! 

 

Click Here for the Advance Directives Pamphlet

An Advance Directive is a written document in which you specify what type of medical care you want in the future, or who you want to make decisions for you, should you lose the ability to make decisions for yourself. Three types are a Durable Power of Attorney for Health Care, a Living Will, and a Do-Not-Resuscitate Declaration. There is also a Declaration of Anatomical Gift, to take effect after your passing. 

 

Patient Registration Form

New patients, please fill this out and bring with you to your appointment. Current patients, please let us know if any information has changed. 

 

Community Resource Directory

National and local resources for specific conditions or individuals.

 

 

*Advance Directives information retrieved from Michigan State Long Term Care Ombudsman Program

*HIPAA information retrieved from the U.S. Department of Health and Human Services

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Depression/Anxiety

Anxiety is the most common mental health disorder among Americans, while depression is the leading cause of disability in the United States.

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Men's Health

We provide expert oversight of men’s health issues for our patients including cancer screenings, sexual health, and overall wellness.

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Allergies

Find relief from your chronic allergies today by calling the office or using the online booking feature.

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Preventative Healthcare

Preventive care is one of the best ways to safeguard your health against some very serious conditions.

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Chronic Disease Management

We are experienced in helping patients better manage their quality of life and prevent complications.

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Diabetes

We help our clients to better manage, and even prevent, this chronic disease.

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High Blood Pressure

We offer high blood pressure solutions to our patients that can reverse this dangerous condition.

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High Cholesterol

We offer diagnostic testing and treatment options, including medication therapies, to address high cholesterol levels.

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Women's Health

We offer specialized, comprehensive women’s healthcare from contraception to reproductive cancer screening.

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Blood Work

We offer in-office blood work for diagnostic and monitoring purposes.

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In House X-Rays

We offer the convenience of in-office X-rays to ensure you get the right treatment and fast.

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Nutrition Counseling

We help to greatly improve your health through nutritional counseling.

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Adolescent Health

Parents can rest easier knowing that their child's healthcare needs are met at our practice.

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Minor Injuries

We are experienced in treating minor wounds and injuries, including skin lacerations, to ensure you heal quickly and fully.

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Skin Care

We have treatment services available to alleviate symptoms and improve the overall health and appearance of your skin.

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Adult Medicine

We have experience for all stages of adulthood.

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Diagnostic Tools

When you are feeling off, and you’re not sure what it is, we can help diagnose you as accurately as possible.

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Pre-op Clearance

We can clear you for your operation with their many years of experience.

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DOT Exams

At Rochester Primary Care, we can help make sure you’re ready for the road.

Location

Rochester Primary Care
1349 S. Rochester Rd., Suite 100
Rochester Hills, MI 48307
Phone: 248-759-5460

Office Hours

Get in touch

248-759-5460