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Forms

New patients are encouraged to download and complete the intake forms prior to their first visit to AxioBionics. Completed forms may be faxed to AxioBionics at
734-327-3715 or emailed to submitforms@axiobionics.com.

All new patients are required to fill out our New Patient Intake Form using the link below. Please complete the form below, sign, and send back to us prior to your Evaluation. Thank you.

The Case Study form is optional.

Existing patients who need to fill out one or more of the forms below, can click on them individually.

For patients wanting to order TripleFlex, please complete the form below.

Self-pay patients are encouraged to complete the AxioBionics Charitable Mission Form below for a reduction in cost.

We can help you start to live your life again: