Patient Forms
New Patient Form
Click below to Download
Patient Consent Form
Click Below to Download
Privacy & Billing Consent Form
Click Below to Download
Patient Communication Form
Click Below to Download
HIPPA Notice of Privacy Practices
Click Below to Download
River City Rheumatology Medical Records Release Form
Click Below to Download
Cancellation / Missed Appointment Policy
Click Below to Download
Portal Message Management
Click Below to Download
PxP Patient Portal
If you are an existing patient and you have provided us with your email address, you will be sent an invitation to join the PxP Patient Portal, which can be found below. If you have any trouble logging in, or if you forget your username or password, the best help can be found by accessing the orange chat bubble at the bottom right corner of the patient portal homepage.
University of Michigan Health-West Patients
How to Request Medical Records
Instructions
Click below to view instructions on how to request your medical records.
Request Form
Click below to download the U of M Medical Record Request form.
Required Information
Below is the required information to include on your request form.
James Birmingham, M.D.
6741 E. Fulton St.
Ada, MI 49301
(616) 320-5330 (phone)
(616) 320-5331 (fax)
rivercityrheum@aara.care (email)
Contact Us
If you need help with required patient forms or want more information, please contact our office at (616) 320-5330.
