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Sports Medicine Patient Registration Form

Sports Medicine Patient Registration Form for McLaren Greater Lansing

McLaren-Greater Lansing Sports Medicine Patient Registration Form
This is a secure site.  Please complete the information below.

* Indicates required information

















These next 10 questions are insurance information





The information below will assist us in your care and in any communications with you,
while protecting your confidentiality. Please review and check 'Yes' or fill in a name
if approved. You may amend this statement at any time. 



If you are a Medicare Recipient, please answer the rest of the questions.
They are required by Medicare: