If you need a more accessible version of this website, click this button on the right. Switch to Accessible Site


You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]


In order to provide you the best possible wellness care, please complete this form

Patient Data

Mailing Address

Current Complaints

Nature of Injury

Insurance Information

*If an auto accident, please provide:


Name of the Insured _____________________________________________

I understand and agree that health/accident insurance policies are an arrangement between an insurance carrier and myself. I understand and agree that all services rendered to me and charged are my personal responsibility for timely payment. I understand that if I suspend or terminate my care/treatment, any fees for professional services rendered to me will be immediately due and payable.

Patient's signature _______________________________________________

Date ____________________

Spouse's or guardian's signature __________________________________

Date ____________________

Medical History

Have you ever:

Family History


Have you ever suffered from:

Exclusive Offer

Our new location is NOW OPEN! 

We constantly strive to provide incredible care to whole families on our quest to create a happier and healthier community here in Novi/Northville, which is why we opened our brand new state-of-the-art facility on October 6, 2017.

We are proud to offer crisp and clear digital X-rays, along with our digital spinal evaluation system to examine the nervous system without radiation exposure (perfect for our expecting moms and little ones!). 

We cannot wait to help you and your family Discover Wellness for Life!

Are you a new patient? Your initial examination is just $67.

Office Hours

Monday10am - 1pm3pm - 6pm
Wednesday7:30am - 1pm3pm - 7pm
Friday7:30am - 1pm3pm- 5pm
Saturday9:30 - 11:30am
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
10am - 1pm 7:30am - 1pm Closed 7:30am - 1pm 9:30 - 11:30am Closed
3pm - 6pm 12pm-3pm 3pm - 7pm 3pm- 5pm

What can we help you find?