PDF document
Patient registration form
Complete your patient information before your visit and bring the form to the clinic.
Patient forms
Download the forms you need and confirm the required paperwork before your visit.
Download PDF: Patient registration form
PDF document
Notice of Privacy Practices
Read how patient health information is used and protected, and learn about your privacy rights.
PDF document
School and sports physical form
Confirm the current form, exam, and signature requirements with your school or sports organization; it may require different paperwork from this download. Call the clinic about age and parent or guardian requirements.
Prepare for a school or sports physicalPDF document
Employer authorization for occupational medicine and workers’ compensation
Your employer can complete this authorization for occupational medicine or a work-related injury visit.
Employment & workplace visit informationPDF document
DOT medical examination report
Call ahead for certified examiner availability and confirm which current forms, identification, and medical records your DOT exam needs.
Prepare for a DOT physicalBring the right paperwork. Your school, employer, or examiner may require a current or different form. Confirm it with them and the clinic before traveling.
Prepare for your visit
A few essentials help the clinic team get started.
01
Choose your clinic
Check hours and directions, then call about a specific test or physical. For a child, confirm age, parent or guardian attendance, and consent requirements.
Find a clinic02
Bring your essentials
Have your photo ID, insurance card if you have one, and medication list ready. Confirm your exact insurance plan or ask the clinic for a self-pay estimate and separate service fees.
Insurance & self-pay information03
Get your forms ready
Bring the current paperwork required by your school, sports organization, employer, or examiner. Check exam and signature requirements before the visit.
Download patient formsQuestions about your visit? Call your clinic.
Choose a clinic for hours, directions, and visit information.
Adrian Urgent Care
715 N Main St
Adrian, MI 49221
Weekdays 7 AM–9 PM
Weekends 8 AM–8 PM
Southgate Urgent Care
14523 Northline Rd
Southgate, MI 48195
Weekdays 9 AM–9 PM
Weekends 9 AM–9 PM
Warren Urgent Care
31700 Van Dyke Ave
Warren, MI 48093
Prospect Urgent Care
417 W Prospect Rd
Ashtabula, OH 44004
Weekdays 9 AM–9 PM
Weekends 10 AM–8 PM