Welcome to North Texas Dermatology
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Locations

Plano Office

972-769-8180
5805 Coit Rd. Suite 203
Plano, TX 75093

Richardson Office

469-326-3376
3600 Shire Blvd. Suite 210
Richardson, TX 75082

Aesthetic and Laser Center

469-246-2062
5805 Coit Rd. Suite 202
Plano, TX 75093

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02/18/2019
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Medical Appointment Request Form

You may request an appointment using this online appointment form, or you may call our office at (469) 326-3376 – Richardson or (972) 769-8180 - Plano. Please allow us one business day to respond to your online request.

New patients can save time by filling out our patient paperwork before you appointment. Download the forms, fill in the fields, print them off, and bring the paperwork with you to your appointment!

If you have any relevant medical records, please bring them with you to your appointment. You may also upload them using this form when you request your appointment.

New Forms are required starting in 2018 for ALL patients for our offices. You can download and fill them out to bring with you or you can arrive 30 minutes prior to your appointment time to fill them out at the office. You must also bring your Driver License/Photo ID AND your current insurance card(s) including Medicare cards to each visit to our office.
NOTE: THIS FORM IS NOT FOR PEOPLE WHO NEED URGENT MEDICAL CARE. IF YOU OR SOMEONE YOU CARE FOR HAS A MEDICAL EMERGENCY, PLEASE CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM IMMEDIATELY.
Please complete the form to request a Medical Appointment

Medical Appointment

  • Please indicate the reason for your visit, and your preferred day and time so that we can better accommodate your request:

  • Secure Upload Appointment Documents

* Required Fields

Locations