Accredited by the Joint Commission

Licensed by the State of Michigan

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© 2019 Hegira Health, Inc.

Admission Documents

For your convenience, you can complete admission documents prior to your first appointment. Please click on the links below to access our forms.  Be sure to print and bring the completed forms with you to your appointment.  If you have any questions about these forms or the admissions process, please let us know.

Adults:

Self Report

History and Physical Health Screen

Children:

Parent/Guardian Self Report

Child/Adolescent Self-Report

History and Physical Health Screen