Digital Waiver

We need your agreement on the following points. Please check the box that you agree and submit this form prior to your appointment. Please call us at (248) 324-3000 with any questions or concerns.

  • - You or someone in your household is ill
    - You have taken a COVID test and are awaiting a response
    - You have experienced fever, dry cough, or Covid-19 symptoms
  • First and Last Name