Application Form

To take part in the Family Centered Experience you will need to fill out an application form. The application is available for you to fill out online or to print out and mail in. In addition to your application you will need to print, sign and mail the Informed Consent form to:

Family Centered Experience
University of Michigan Health System
Office of Health Equity and Inclusion
7330 Medical Science Building 1
1301 Catherine St.
Ann Arbor, MI 48109-5624
(866) 337-0017 (toll-free)

Application Form (Online Version)
Informed Consent (Download and Print)