Brian Kirschner, M.D.
Brian Kirschner, M.D.

New Patient Forms

Want to save time during your visit with us? Please print and fill out the following forms and bring with you on your first appointment.

New Patient Packet.doc
Microsoft Word document [520.5 KB]

Don't forget to bring your insurance information with you.

In order to register and treat you promptly, we request that our patients bring their current insurance information with them for each visit.

We accept most types of health insurance. Please contact us for further details.

Established Patient Forms

Records Release.doc
Microsoft Word document [220.5 KB]
Seizure Safety.doc
Microsoft Word document [211.0 KB]
Patient Notice of Privacy Practices.doc
Microsoft Word document [82.5 KB]

Franklin Neurology

Millennium Medical Group
A Division of Michigan Heathcare Professionals, P.C. 
32255 Northwestern Hwy.

Suite 40
Farmington Hills, MI 48334
248 355-3875 248 355-3875 phone
248 355-3857 fax

Office Hours

Mon-Thu :

08:00 am - 04:00 pm

Fri :

08:00 am - 12:00 pm

Print Print | Sitemap
© Dr. Brian Kirschner