Patient Forms

Click on the links below to download OrthoMichigan's available patient forms. Please contact our office with questions by calling our Flint location at (810) 733-1200, our Lapeer location at (810) 667-6110 or our Fenton location at (810) 593-0023. 



On the day of your appointment, it is extremely important that you bring any and all information related to your condition. This includes x-rays, MRI’s, CT scans, test results, office notes, and previous surgical/operative reports.


Patient Information Form

Patient Medical History Form

Dr. Fernandez’s Back Form


Additional information