Patient Forms

Easily access our patient forms.

Please complete the new patient forms and bring them with you to your first visit in the office. In order to complete a New Patient Form, you are required to sign that you have read the HIPAA Notice of Privacy form.  

Also, on the day of your appointment, please bring a photo ID, your insurance card, and a valid form of payment for any co-pay required by your insurance.

Patient Forms
New Patient Demographics [PDF]
Acknowledgement of Office & Financial Policies [PDF]
HIPAA Notice of Privacy Practices [PDF]
Medical History Form [PDF]

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Modern dermatology clinic located in the greater Houston area