Patient Forms

Getting Ready for Your Visit

Thank you for choosing U.S. Dermatology Partners for your skincare needs! We appreciate the opportunity to care for your health. Please begin the registration process by completing our patient forms online at MySkinPortal.USDermatologyPartners.com

New Patients

New patients, please complete our patient forms online. You can access this link on your desktop computer or mobile phone. No app is required. All your information will be submitted electronically, and you do not need to print the completed patient forms.

Established Patients

If you are an established patient, and your demographic information has changed within the last three years (address, phone, email, etc.), please complete our patient forms online.

Complete Online Forms

Alternatively, you can print our patient forms, fill them out, and bring them into the office during your appointment.


Remember to Bring

Please remember to bring the following to your appointment:

To expedite the check-in process, please arrive 10-15 minutes prior to your scheduled appointment time.


Insurance

We accept most major insurance carriers. Find the complete list of insurance carriers that we accept here. However, please contact your insurance company prior to scheduling your appointment to verify the specifics of your coverage. Also, it is important to ask your insurance carrier if any referral, pre-authorization, or pre-certification is necessary before you schedule your appointment with us. HMO carriers require preauthorization prior to treatment.

Please note, we do not accept any Medicaid insurance plans.


Payment

Payment is due at the time services are rendered. The amount collected is estimated based on the benefits information available. Specific policy information is often limited or unavailable until after a claim has been filed. Insurance coverage is not a guarantee of payment. The patient is responsible for any remaining balance not covered by insurance.

Our office requires a credit card to be kept on file for payment of any co-payment, co-insurance, deductible, or charge that may not be covered by your health insurance. For more information about our credit card on file policy, please review our frequently asked questions.


Late Arrivals

We understand that sometimes you may be delayed. However, late arrivals may require rescheduling. U.S. Dermatology Partners reserves the right to charge a fee if the appointment is not canceled at least 24 hours in advance. Special types of appointments require a deposit to reserve the appointment date. U.S. Dermatology Partners reserves the right to charge a fee or retain the deposit if the appointment is not canceled at least 72 hours in advance.


Minor Consent

If the patient is a minor (under 18 years of age), the parent or legal guardian must be present at the child’s initial visit to sign the Consent to Treat Minors form. Without a signed consent form, we cannot legally treat a minor child. The form allows you to list other adults who can accompany your child or if your child can arrive unaccompanied for future visits. If you are unable to attend the first visit with your child, you may sign the notary version of the parental consent form. If you are the child’s legal guardian (not a parent), you will need to confirm this by providing legal documentation. This information will be kept in the child’s file.


Medical Records Release

For patients who require medical records to be released, please print and complete the following authorization form and return it to your doctor’s office.