Trinity Health Business Card Form
Trinity Business Card
*
indicates required field
Name (as it would appear on the business card)
What is your home clinic location?
- Select Clinic -
Admin - 3075 West Clark Rd Suite 200 Ypsilanti, MI 48197
Ann Arbor - Domino’s Farms - 4200 Whitehall Dr. Suite 210 Ann Arbor, MI 48105 Phone: 734-712-7171 Fax: 312-579-3291
Ann Arnor - North Arbor - 1665 Plymouth Rd Ann Arbor, MI 48105 Phone: 734-712-0300
Ann Arbor - State Street - 2058 S State St Ann Arbor, MI 48103 Phone: 734-712-0300 Fax: 312-416-4746
Ann Arbor - West Arbor - 4350 Jackson Rd Suite 360 Ann Arbor, Mi 48103 Phone: 734-712-9630 Fax: 312-428-4060
Ann Arbor - Westgate - 2577 Jackson Ave Ann Arbor, MI 48103 Phone: 734-929-6400 Fax: 312-428-4057
Brighton - 8701 W Grand River Ave Brighton, MI 48116 Phone: 810-844-7544 Fax: 312-436-2519
Canton - Canton Center - 1600 S Canton Center Rd Suite 330 Canton, MI 48188 Phone: 734-398-7500 Fax: 312-436-2815
Canton - Canton Lilley - 180 S Lilley Rd Canton, MI 48188 Phone: 734-398-0668 Fax: 312-436-2815
Chelsea - 14800 Old US 12 Hwy Chelsea, MI 48118 Phone: 734-593-6370 Fax: 312-436-2820
Clinton - 11775 Tecumseh-Clinton Hwy Suite 300 Clinton, MI 49236 Phone: 517-545-5340 Fax: 312-548-9692
Howell - 620 Byron Rd Howell, MI 48843 Phone: 517-545-6333 Fax: 312-579-3301
Livonia - Schoolcraft Campus - 19000 St Joe’s Pkwy Suite 450 Livonia, MI 48152 Phone: 734-743-4433 Fax: 312-957-3919
Livonia - Livonia Southeast - 29370 Plymouth Rd Suite 400 Livonia, MI 48150 Phone: 734-743-4433 Fax: 312-957-3919
Pinckney - 10200 Dexter-Pinckney Rd. Suite 400 Pinckney, MI 48169 Phone: 734-712-2750
Plymouth - 990 W Ann Arbor Trail Suite 103 Plymouth, MI 48170 Phone: 734-414-1000 Fax: 312-361-8086
Saline - 7115 E Michigan Ave Suite 400 Saline, MI 48176 Phone: 734-712-5151 Fax: 312-300-5683
Ypsilanti - Carpenter - 3069 Carpenter Rd Ypsilanti, MI 48197 Phone: 734-712-3563 Fax: 312-436-2817
Ypsilanti - Clark - 3145 W Clark Rd Suite 102 Ypsilanti, MI 48197 Phone: 734-5289760 Fax: 312-548-9691
Ypsilanti - East Ypsilanti - 1159 E Michigan Ave Suite E Ypsilanti, MI 48198 Phone: 734-712-1589 Fax: 312-548-9691
Ypsilanti - Pediatric Rehabilitation - 3075 W Clark Rd Suite 108 Ypsilanti, MI 48197 Phone: 734-712-0566 Fax 312-429-0300
Ypsilanti - Pelvic Health - 3145 W Clark Rd Suite 106 Ypsilanti, MI 48197 Phone 734-712-0142 Fax: 312-957-2959
Office Phone
Phone/Mobile
If your location is in the admin building please specify phone number & fax number for your business card
Fax
Your Trinity Health Email
Which title should be listed on your business card?
Select only one option.
- Select -
Clinic Director
Physical Therapist
Physical Therapist Assistant
Occupational Therapist
Athletic Trainer
Other
Other Title
If title not listed above, please enter your Title. Title may need to be approved by leadership.
Which credentials should be listed on your business card?
Maximum of 4 allowed
- Select -
AT
Board Certified Women’s Health Specialist
CCC-SLP
CDN
CHT
CIMT
COMT
CSCS
DPT
LVST
M.S.
MOT
MS
MSOT
OCS
OMPT
OTR / CHT
PT
PTA
Schroth-Certified
None
Please list approved credentials from previous question in preferred order
Maximum of 4
Are there any other details you would like to know when placing your order?
Maximum of 4
Submit Form
