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Patient Forms

Appointment RequestPatient Forms

The Pregnancy Checkup

The pregnancy checkup is a quick survey that will help your doctor care for you while you are pregnant. Your doctor would like you to complete the survey before you come to our appointment. Visit http://www.ht-2.org/mmob to complete the survey. This survey takes approximately 20 minutes.

If you would like copies of your medical records or are transferring to a different health care provider and need records sent, please print and fill out form below and send to your new provider or fax to our office at (989)631-4398:

Medical Records Release

Please review the telemedicine consent and sign it. Your provider will ask that you show it to them at the start of your appointment:

Telemedicine Consent

SEEK Program in Midland County

SEEK