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  • Services
    • Medical Dermatology
    • Dermatologic Surgery
    • Superficial Radiation Therapy (SRT)
    • Cosmetic Dermatology
    • Plastic Surgery
    • RESTORE Hair Restoration
    • Total Body Skin Exams
    • Retail Products
  • Our Locations
  • Our Providers
    • Medical Providers
    • Cosmetic Providers
    • Aesthetic Specialists
  • Patient Resources
    • Coronavirus Update
    • Telemedicine
    • Patient Portal
    • Patient Forms
    • Pinnacle Online
    • Events and Specials
  • Physician Resources
    • Referrals
    • Sell Your Practice
    • Start a New Location
    • Utilize Centralized Pathology
  • About Us
    • About Us
    • Total Body Skin Exam
    • Reviews
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Patient Forms and Policies

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patient forms

New Patient Forms

You may download our patient forms and fill them out in advance to save time when you come in for your consultation.

  • New Patient Paperwork
  • Verbal Release of Information Form
  • Notice of Privacy Practices

Other Forms and Policies

  • Medicare Patient Form
  • Self Pay Pathology Form
  • Treatment to Minors Form
  • Universal Procedural Consent Form
  • Disability Insurance Form
  • Credit Card Authorization Form
  • Patient Financial Responsibility Form
  • Notice of Privacy Practices
  • Cancellation Policy
  • Intake and History Form
  • Medical Release Form
  • Patient Registration Form
  • Patient Call Authorization Form

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