Call Today (248) 669-2000
The Lakes Medical Center
2300 Haggerty Road, Suite 1110
West Bloomfield, Michigan 48323

Beaumont Botsford Hospital
28080 Grand River Avenue, Suite 208N
Farmington Hills, MI 48336

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Patient Forms

Thank you for selecting Lederman Kwartowitz Center for Orthopedics & Sports Medicine in West Bloomfield and Farmington Hills, Michigan for your orthopedic and physical therapy care. To schedule an appointment, please call us at (248) 669-2000 or use our online appointment request form.

Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

New Patients:

Existing Patients:

Record Requests:

Note: Our medical records releases, disability, and FMLA forms are now completed by a third party company called BACTES. If you have a request for medical records or disability/FMLA forms that need to be filled out, please print out the medical records release, disability or FMLA records release form(s) below. 

Once the release forms are filled out completely, please mail or fax them along with your disability/FMLA forms to our office. We can then release your medical information to BACTES. *You must indicate the type of form to be completed: records release, disability, or FMLA.*

There is a $25.00 administration fee that must be paid in full before forms can be completed. This payment can be made with a credit card by phone at (248) 977-3926 or mailed to BACTES at:

BACTES Imaging Solutions
7080 N. Opdyke Road, Suite 217
Auburn Hills, MI 48326

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

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