This page is for new patients who have been accepted into the practice.
If you are looking for information on how to become a new patient, please see our FAQS page.
We respect you as a patient and invite you to read our "Notice of Privacy Practices".
If you are looking for information on how to become a new patient, please see our FAQS page.
We respect you as a patient and invite you to read our "Notice of Privacy Practices".
Paperwork for Dr. Dakroub, Dr. Zager, Brenna Reichman, and Paula Esteva Slack:
**Continue scrolling down for Abby Humphrey's paperwork, do not use these forms**
Please print and fill out both sets of paperwork and return them to us either by email ([email protected]), fax (734-547-3980) or mail along with a copy of both the front and back of your driver's license and insurance cards. You can also text the photo of your driver's license/insurance card to 734-547-3990.
- New Patient Registration Form
- New Patient History Form (for adult patients only)
- Privacy Policy (Please read - no need to print or return
Attention Dr. Dakroub, Dr. Zager and Paula Esteva Slack patients, you will also receive the history form electronically via email prior to your first appointment. This is the preferred method to complete the history form, if you do not receive the email please use the history form above.
You should receive an email appointment reminder both one week before and one day before your appointment
**Cancellation or changes to your appointment must be made at least 1 full business day prior to the time of your appointment otherwise there is a $75 charge for the visit.
Other Forms:
Abby Humphrey
Patient Fusion - Joining our Patient Portal
Getting lab results and communicating with your care provider is easy through our portal, "Patient Fusion". After your first visit, you should receive an invitation specifically to join the patient portal Follow the directions to create your account using either a phone number or a code that our office can supply. If you prefer to use the code, please give our office a call. If you have any questions about Patient Fusion, they have an excellent site at: help.patientfusion.com/knowledgebase/articles/714102-how-do-i-register-my-patient-fusion-account
Getting lab results and communicating with your care provider is easy through our portal, "Patient Fusion". After your first visit, you should receive an invitation specifically to join the patient portal Follow the directions to create your account using either a phone number or a code that our office can supply. If you prefer to use the code, please give our office a call. If you have any questions about Patient Fusion, they have an excellent site at: help.patientfusion.com/knowledgebase/articles/714102-how-do-i-register-my-patient-fusion-account