Welcome New Patients!

Summit Regenerative Health offers our patient form(s) online so they can be completed in the convenience of your own home or office.

Please download, print and provide the requested information on the form(s) below.

Once completed, you can fax them to (248) 683-0256, email them to or bring them with you for your first appointment.

By completing the Health History Form (Required), you’ll gain insight into your health history and the current state of your health. In addition, you can let us know what questions, concerns and goals you have regarding your wellness.

The Member Wellness Registration Form (optional) can be filled out to register for access to the member wellness section of our website.