New Patient Paperwork

New Dermatology Patients

Provided is a downloadable version of our new patient paperwork. If you wish to complete this paperwork prior to your initial visit, please fill-out both sides (immunizations are not necessary) and sign our patient privacy policy consent form. If you prefer, you may wait to receive a copy of these forms in our office to be filled-out on the day of your initial visit.

Please note that if you are a Medicare patient, we will need a copy of your Medicare card.

New Patient Paperwork (PDF format)

Patient Privacy Form (PDF format)

Prescription Availability

We are now able to fill your prescriptions prescribed here in the office. We are competitive with pharmacy prices and in most cases our prices are lower. You will receive a receipt acceptable for insurance purposes. We do not accept pharmacy prescription cards so it may be more economical to use your pharmacy in this case.

Insurance Billing Instructions

You will be given a standard insurance report which is acceptable to all insurance companies. Please attach this form to your completed insurance form and submit directly to your insurance company.

Please call us if you have any questions.

Additional Information: