New Patient Request Form
Northern Pines Health Center welcomes new patients!
If you're interested in becoming a new patient at Northern Pines Health Center please complete the "New Patient Request Form" and return it to our office. Once we receive your completed form , our healthcare providers will review it to determine if the services we provide in our office will meet your needs. After a determination has been made we will contact you to either schedule an appointment or inform you that we are not able to meet your healthcare needs in our office.
You may return the new patient request form by mailing it to our office at: 11293 N M37 Suite A, Buckley, MI 49620 or delivering the form to our office during normal business hours. To protect your privacy, we do not currently accept new patient request forms via email.
You may access the new patient request form by clicking on the link below.