The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current medical insurance information. If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.
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Health History | |
Patient Registration | |
Consent To Treat Minor | |||
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HIPAA Consent | |
Medical Records Release Form |
Need Adobe Acrobat Reader?
If you do not have a copy of Acrobat Reader you can get one for free by clicking on the icon ‘Get Acrobat® Reader’. This will take you to Adobe’s website and enable you to download the Acrobat program to your computer.
Map and Directions on our Contact Page
Please bring a list of all your current medications.
If you have any medical records regarding prior care for your skin problem, please bring them or have them sent by the appropriate care provider.
When you call our office for an appointment, you will be conveniently greeted by one of or staff members-not an automated answering system!
If, for any reason you cannot keep a scheduled appointment, or will be delayed, please call us as soon as possible.
Insurances we accept include Blue Cross/Blue Shield, Health Partners, Humana, Medica, Medicare, U-Care, and most private insurers such as Aetna. Please contact our office to verify acceptance of your plan. Qualifications for insurance coverage may differ due to the uniqueness of each procedure.
We accept checks, cash or credit cards. We also offer a flexible payment plan.
Just visit the American Academy of Dermatology website. On the left side of this webpage select the first letter of the disease or lesion you are interested in.
Patient Education from VivaCare
American Academy of Dermatology:
National Alopecia Areata Foundation
American Board of Internal Medicine
