New Patient Documents

New Patient Documents

We are in the process of implementing a new patient portal system and some of our forms have now moved.

To complete your Registration forms, please follow the directions below:

1. Click Registration Form
2. Click on the Purple Words “Create One Now”
3. Enter Last Name and Security Code
4. Enter the User Name and a Password that you would remember
5. Click on the Demographic Tab and Review your Information and click to SAVE to submit
6. Click on Insurance Tab and Review your Insurance Information.  IF YOU HAVE ANY CHANGES OR INFORMATION IS INCOMPLETE ON THIS FORM, PLEASE CALL OUR OFFICE TO UPDATE
7. Click on the Form Tab and Complete Dermatology Online History and click on Submit at bottom of page.

Thank you for completing your information online!

Registration Form

HIPAA Statement