New Patient Information

Please print out the following two forms and bring them with you to your appointment:

Patient Registration
Dermatology Medical History

Insurance Information

We are now accepting Care Credit to assist patients who are self pay, have high deductibles, or for cosmetic procedures. We accept patients from the following plans:

Aetna	Humana
Beech Street	Medicare
Blue Cross/Blue Shield	Multiplan
CCN	PHCS
Cigna	Southcare
First Health	Tricare Standard/For Life
Great West	United
Health Options

Preparing for your appointment

• Please avoid using any fragrances, perfumes, cologne, etc on the day of your appointment due to allergies of other patients as well as staff members.
• If you want to have your face and/or nails examined please remove makeup and nail polish prior to visiting the office.
• Please bring your current insurance card and valid photo identification.
• If you are on Humana HMO, please make sure you have the proper prior authorizations for procedures.