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T.J. NUGENT DC, PLC offers our patient form(s) online so you can complete it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This let's us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Insurance Authorization / Assignment and Patient Payment Agreement Form

Download & Print Form



Download the Free AdobeReader®

New Patients Welcome

Now accepting new patients!
Reserve your appointment by calling us at 989-835-8330 or by using the form below

Office Hours

DayMorningAfternoon
Monday9:00 - 1:003:00 - 6:00
Tuesday9:00 - 1:00Closed
Wednesday9:00 - 1:003:00 - 6:00
Thursday9:00 - 1:00Closed
Friday9:00 - 1:003:00 - 6:00
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00 - 1:00 9:00 - 1:00 9:00 - 1:00 9:00 - 1:00 9:00 - 1:00 Closed Closed
3:00 - 6:00 Closed 3:00 - 6:00 Closed 3:00 - 6:00 Closed Closed