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Contact Us At:
Jonna L. Schmidt MD
458 Cross Street
PO Box 270
Hudson, MI 49247

Phone: 517.448.8918
Fax: 517.448.4085
After Hours: 517.265.0900

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Downloadable Forms


Listed below are the forms for new patients to fill out. To save some time on your first visit to our office, you can fill the new patient paperwork online. Click on the new patient form to fill it out, and when you've finished with a form, come back to this page to continue.

New Patient Form

The following forms require a signature. You may view this forms online to see what they entail, and you may also download a PDF of each form to print, sign, and bring to our office on your first visit.

Insurance Authorization [Read Only]
Insurance Authorization [PDF]

HIPPA PHI Authorization [Read Only]
HIPPA PHI Authorization [PDF]

Privacy Release [Read Only]
Privacy Release [PDF]

Consent By Proxy [PDF]


Below are our cholesterol and diabetes handouts. Please feel free to download these, in PDF format.


Below are the Hudson Schools Sports Physical Forms. Click to download in PDF format.

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