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Patient Information

New Patient Forms What to Bring to the Appointment Notice of Privacy Practices Insurance and Payment Information

Physician Appointment Locations Hospital Affiliations Renal Transplantation Facilities Dialysis Facilities

New Patient Forms

New patients need to complete the following two forms. Using the links below, you can download and print the forms. Please complete them and bring them to the first appointment.

• Notice of Privacy Practices Acknowledgement
• Patient information registration sheet

What to Bring to the Appointment

First-time patients should arrive early in order to complete a patient registration form. Please bring the following items to the appointment:

• Patient's insurance card
• Physician referral forms if required by insurance
• A list of current prescriptions and/or over-the-counter medications, including dose and frequency
• Any recent test results

Insurance and Payment Information

Michigan Kidney Consultants, P.C., is a provider for Medicare and most major insurance plans. We provide insurance billing. Please be aware that any costs not covered by insurance are your responsibility.

For services that are not covered by insurance, we request payment at the time of your appointment. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.

If you have any questions regarding which insurance plans we accept or any billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

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Hospital Affiliations

• St. John Hospital, Detroit
• Detroit Medical Center, Sinai Grace Hospital, Detroit
• St. Mary's Hospital, Livonia
• North Oakland Medical Center, Pontiac
• Pontiac Osteopathic Hospital, Pontiac
• St. Joseph Mercy Hospital, Pontiac
• Huron Valley Hospital, Pontiac
• Crittenton Hospital, Rochester
• William Beaumont Hospital, Royal Oak and Troy
• Providence Hospital, Southfield
• St. John Macomb Hospital, Warren

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Renal Transplantation Facilities

Our physicians work closely with the following centers to facilitate renal transplantations:

• William Beaumont Hospital, Royal Oak
• University of Michigan Medical Center, Ann Arbor
• St. John Hospital, Detroit
• Henry Ford Hospital, Detroit

Feature Sample:
Filmmaking at the beginning of the twentieth century was in it's infancy. The techniques at that time could only show people and objects as they were, with an occasional photographic trick. As technology progressed, so did the effects we see on film. We no longer find it amazing that a star ship can appear to rush through space at "warp speed". We see whole cities demolished, knowing they are truly intact, and accept this as the norm. So to envision people flocking to a theater to see a movie that was entirely silent is a bit incredulous to us now. But that was the reality of the early twentieth century.