Contact Information and Forms
We look forward to hearing from you! Please see below for office
locations, contact information, most requested departments and forms
to fill out before you arrive. To schedule an appointment, follow
up on a recent visit, or simply ask a few questions, please call,
write, or send us an e-mail.
Hablamos Español !
Main Office
Billing and Insurance questions
1111 Leffingwell N.E.
Suite 200
Grand Rapids, MI 49525
Phone:
(616) 957-4263
Fax: (616) 957-0444
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Mary Free Bed
235 Wealthy SE
Grand Rapids, MI 49503
Phone: (616) 242-0481
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United Memorial Medical Specialty Center
705 S. Greenville West Dr.
Greenville, MI 48838
Phone: (616) 957-4263
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South Pavilion
80 68th St
Grand Rapids, MI 49548
Phone: (616) 391-8230
Fax: (616) 391-8269
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Billing Questions
E-mail: billing@michiganhand.com
Insurance Information
E-mail: insurance@michiganhand.com
Forms
To save time when you come to the Michigan Hand Center for your appointment, print out the forms below and fill them out at home. Then, don't forget them when you come for you visit! We look forward to seeing you.
Patient Information Form (PDF)
234 kb
Consent for Treatment Form (PDF) 12 kb
Medical History Form (PDF) 98 kb
HIPAA
Form (PDF) 83 kb
Notice of Privacy Practice (PDF) 80 kb
Financial Policy (PDF) 74 kb
Priority
Health Questionnaire Form
(PDF) 401 kb
Web Site Terms of Use Agreement
Please read our Terms of Use.
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