Patient Forms - American Regenerative Clinic

Welcome to our American Regenerative Clinic
Mon – Fri: 9:00 am – 5:30 pm

Follow Us:

Our Location 31000 Telegraph Rd., Ste. 140,
Bingham Farms, MI 48025
Send Us Email contact@americanregen.com
Call Us Now (248) 876-4242

Home
Dr. Andrey Lutskovsky
Aesthetic Services
Regenerative services
Patient Information
Contact us

Book a consultation

Patient Forms

Home
Patient Forms

Please click on the links to download the forms.

Consultation
(Functional Medicine) Female Intake Questionnaire (.pdf)
(Functional Medicine) Male Intake Questionnaire (.pdf)
Medical Symptoms Questionnaire (.pdf)

Quick Links

Home
Regenerative Services
Aesthetic Services
Patient Information
Contact Us
Website Disclaimer

Before & After
Testimonials
FAQs
Blog
News
Patient Forms

Contact Us

ADDRESS 31000 Telegraph Rd., Ste. 140, Bingham Farms, MI 48025
PHONE (248) 876-4242
Email contact@americanregen.com
WORKING DAYS/HOURS Mon – Fri: 9:00 am – 5:30 pm

Subscribe to Newsletter

4.7 Out of 70
5 Out of 21

© Copyright 2020 - 2023 | American Regenerative Clinic | All Rights Reserved.

Website Development by B3NET.com

We use cookies to ensure that we give you the best experience on our website. If you continue to use this site we will assume that you are happy with it.Ok