ann arbor mini brochure for physicians virtual tour ann arbor spine center  
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Ann Arbor: 5315 Elliott Dr. #102
Ypsilanti, MI 48197 | 734-434-4110
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Appointmentspic

For your initial appointment at Ann Arbor Spine Center, please arrive 15 minutes before your scheduled appointment. This will allow us sufficient time to complete all of the necessary paperwork. Disclaimer: If you have an emergency you should go to a hospital or call 911. Do NOT call the numbers below for emergencies.

Our offices are open from 9:00 a.m. to 4:30 p.m. from Monday through Friday. To schedule an appointment please call us at:

Ann Arbor Office:

Call us locally at (734) 434-4110 x 51661
Toll free at 1 (800) 824-9253 x 51661
Have your doctor fax a referral form (located under the "Patient Forms" tab) to (734) 434-1966

Chelsea Office:

Call us locally at (734) 433-4504
Have your doctor fax a referral form (located under the "Patient Forms" tab) to (734) 434-1966
Please call us at least 24 hours in advance if you need to cancel your scheduled appointment. We charge $50 for appointments not cancelled at least 24 hours in advance.

New Patient Information:  If you are a new patient, you can get a referral from your physician to our practice or you can call the office and get an appointment without a referral (Dr. Falahee only). Either way, we are happy to see you. Your insurance company may have specific referral requirements as well. You can expedite this process by making sure we have all of the necessary information listed below prior to your first appointment.

   1. Referral from Primary Care Physician (PCP)
   2. Referral authorization from your insurance carrier
   3. Your insurance card
   4. Copy of your medical record
   5. Results of any recent tests pertaining to your condition
   6. X-rays, CT scans, or MRI films (original copies)

If you have any questions about any of the items above, please call our office during business hours.

 

Fill out the form below to pre-register for an appointment. Someone from our staff will contact you shortly. Thank you.

*required

Patient Pre-Registration Form

*First name, *Last name

*Address

*City, *State, *Zip
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*E-mail address

Phone number, Fax number
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Guarantor name

Insurance company name

Worker's compensation information. If your injury happened at work and qualifies for worker's compensation, please complete this section.

Worker's comp/MVA claim number, Date of injury
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Employer Information

First name, Last name

Address

City, State, Zip
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Phone number, Fax number
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Name of referring and/or PCP physician

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