Secure Online Forms
For your convenience, several secure, online forms are available for your use. Under Facility, use the Botsford Clinic System form to pay your bill.
- Online Payment
You can use this convenient online form to pay your bill from our office. Please fill out all areas.
- Patient Registration
For our new patients. You can help us with your registration by filling out this form and submitting it prior to your first appointment.
- Prescription Renewal Request
Please use this form to request a prescription renewal from our office. We will respond within one business day.