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GTIFM Forms
Grand Traverse Internal and Family Medicine, P.C.
5015 N. Royal Dr. Traverse City, MI 49684
5015 N. Royal Dr. Traverse City, MI 49684
Forms
Request to Become A New Patient Form (for patients without appointments only)
TCAPS Medication Authorization Form
New Patients Form (for patients with appointments only)
Consent for Treatment While Parent Away
Endocrinology New Patient Forms (for patients with appointments only)
Medical Records Release Form (asking former physician to send records to us)
Requesting Records To Be Sent To Us Form
Medical Records Release Form (asking us to send records to another office)
Policies and Flyers
Welcome Letter
Notice of Privacy Practices for Patients
Financial Policy
PCMH Brochure
Care Management Flyer