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.
New Patients: You can help us with your registration by filling out the forms below and bring them to your first appointment.
- Adult History
- Authorization for Treatment
- Medication Record
- Patient Registration
- Privacy Notice Acknowlegement
- Rapid5 Multidimensional Health Assessment Questionnaire (MDHAQ)