PATIENT FORMS
Save Time
at Check-In
you need before you arrive.
9+ Convenient Locations
Care close to home.
Short Wait Times
Get in. Get out. Get better.
Most Insurance Accepted
Care made easy.
Telemed Visits Available
Care wherever you are.
PATIENT FORMS IN LANSING
Forms Made Easy,
Just For You
Download Patient Forms
Please click on any of the below forms. You can print, fill out, and either fax to our offices OR bring the form(s) with you to your next visit.
Consent Assignment
& Release
Authorize treatment and allow billing to insurance when applicable.
Minor
Authorization
Grant permission for a minor to receive care without a parent present.
Notice of
Privacy Policies
Explains how your medical information is used and protected.
Occupational Health
Services Request
Request occupational health services for employees or job candidates.
Occupational Health Services Client Information
Collect company information and contact details for occupational health services
MHSAA Sports
Physical Form
Required physical form for student athletes participating in school sports.
Release of
Medical Records
Allow medical records to be shared with approved individuals or providers.
Email Communications Consent
Give permission to receive appointment and care-related emails.
Please fax completed forms to: 517.333.9201
Have Questions
About a Form?
our team is happy to help!
be seen from home.
- our services in lansing
Healthcare is our Specialty
Whether it’s a sprain, sore throat, or school physical, Lansing Urgent Care is here for life’s unexpected moments. Our skilled medical team offers a wide range of walk in services so you can get quality care, close to home, without the long wait or high cost of the ER.
Cuts, Wounds & Procedures
minor procedures with fast treatment to help you
heal quickly.
Illness & Infection Care
Injury & Pain Care
Occupational & Employer Services
Physicals & Exams
physicals with walk in
availability any day and no appointment needed.
Testing & Diagnostics
On-site Medications
One Visit. Complete Care. Get the evaluation and treatment you need, with medications available on site when appropriate.
Virtual Care
with convenient online visits
for common illnesses and
follow-ups.
Get seen sooner!
place in line. No appointment needed
at any of our 9 locations.