Home arrow Patient Info
Patient Information PDF Print

***New Patients and Patients not seen within the last six months***


 Please contact your insurance provider to verify that we are in your Preferred Provider network. If not, we will bill most insurance providers but are unable to guarantee full coverage and you will be responsible for the remaining balance. Please call us to find out if your insurance is on our list.

Once you have scheduled an appointment you can either fill out the registration forms at home, to save time in our waiting room; or you can come in 15-20 minutes before your appointment to fill out the paperwork. The necessary forms include Patient Registration, Medical History and HIPAA patient privacy.



 We appreciate at least 24 hour cancellation notice.


Payments Services and Insurance

 If we are a member of your insurance plan, we will submit a claim on your behalf with payment due according to the appropriate provider contract. A current insurance card must be presented prior to services being rendered if you wish to have your insurance billed. Any office visit or surgical copay is due at time of service.

Please be aware that the filing of insurance claims does not guarantee payment by your carrier. Frequently, proof of eligibility, covered and non covered services and various exclusions cannot be determined until your carrier processes the claim. Therefore, we do submit insurance claims with the understanding that you are responsible for any non-covered services as well as co-payments and deductibles.

All cosmetic procedures are not covered by insurance plans. Please be prepared to pay at the time of service for any cosmetic procedure. Our Skin Care Clinic will never bill insurance for any procedure or product.


Medical Records and Release Forms

We are pleased to comply with all requests to release copies of your medical records. To request your records please download the following forms based on your specific need.


To have your records released to us or from us please fill out this form.