Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Please review your responses carefully before submitting, changes are NOT allowed once your information is submitted.

Please select the office, and click below to register online:

Riley – North Holland Office

ONLINE PATIENT REGISTRATION


Michigan Ave.- South Holland Office

ONLINE PATIENT REGISTRATION


Grandville Office

ONLINE PATIENT REGISTRATION


Grand Haven Office

ONLINE PATIENT REGISTRATION