FORMS

Step 1:  Please save the required forms, prior to completing them.  Download Adobe Reader X for free here.

 

1. Consent to Treatment (must be returned prior to appointment)

2. Intake Packet:

3. PCP Form (select the physical office location below):

4. Symptoms Screening Tools


Step 2:  Please email the completed forms to: 
Plymouthstaff@refresh-mi.com

Please note: These forms are in Portable Document Format (pdf) and require a pdf reader. If your computer does not have a pdf reader, you may download Adobe Reader X for free here.

Reader X download note: The download is preset to automatically include, for free, both the Google Chrome Internet Browser and the Google Toolbar for Internet Explorer. These are optional and are NOT required to view and/or print Heron Ridge Associates forms. If you do NOT want them included in your download, be sure to CLEAR the check box called “Yes, install Chrome as my default browser and Google Toolbar for Internet Explorer – optional.(32.11 MB)”.