810-853-5875
Michigan's Top Visiting Providers | Comprehensive Home-Based Medical Care
Patient Resources
Patient Intake Forms
Directions: (very important please read)
The first 5 forms listed below will open in a new window/tab. Please fill out and submit, then close that tab to come back to this page to open the next form.
Please follow this process until the first 5 forms have been submitted electronically.
The Patient Checklist and FAQs you may open and save/or print for your records.
Please take your time and submit all information accurately.
This ONLY works on a computer, laptop or tablet.
New Patient Info Form
Authorization Form
Consent Form
Opiod Form
Info Release Form
Patient Checklist
FAQs
Payment Options
Advanced Medical House Call patients will have a co-pay, although Medicare and most other insurances will cover the majority of the cost of a visit. It is your responsibility to make sure that house call visits are covered by your insurance prior to the first visit. Most insurance cards have a toll free phone number located on the back of your card. Fees are comparable to a doctor’s office. There are no additional charges based on where you live within our service area.
See the map below for current service areas. We are growing and adding new service locations regularly.
Want to make a payment? Please use the form at the bottom of this page to complete a secure transaction.
Additional Resources
Medicare is health insurance for people ages 65 and older
Different Parts of Medicare: The different parts of Medicare help cover specific services.
Medicare Part A (Hospital Insurance):
Helps cover inpatient care in hospitals. Helps cover skilled nursing facility, hospice and home health care.
Medicare Part B (Medical Insurance):
Helps cover doctors’ services, outpatient care, and home health care. Helps cover some preventive services to help maintain your health and keep certain illnesses from getting worse.
Medicare Part C (Medicare Advantage Plans-like HMO or PPO):
A health coverage option run by private insurance companies approved by and under contract with Medicare. Includes Part A, Part B and usually other coverage like prescription drugs.
Medicare Part D (Medicare Prescription Drug Coverage):
A prescription drug option run by private insurance companies approved by and under contract with Medicare. Helps cover the cost of prescription drugs. May help lower your prescription drug costs and help protect against higher costs in the future.
Medicare the official U.S government site – http://www.medicare.gov/