To Our Valued New Patient
Thank you for choosing treatment at Summit Dermatology, P.C. We look forward to helping you with your dermatologic needs. For your convenience, we use an automated telephone reminder system, which will notify you of the date and time of your appointment two days beforehand. However, we do require our patients to arrive 20 minutes prior to their scheduled appointment time. This allows us time to prepare your chart and collect any applicable co-pays. If it becomes necessary for you to cancel your appointment, please notify us 24 hours in advance. Minors (under 18 years of age) are required to bring a parent or legal guardian to the first appointment.
Please view and download the forms that are required for your first visit:
- Medical History Form
- Patient Information Form
- Cancellation No Show & Late Policy
- Consent and Pharmacy Form
- Notice of Health Information Privacy Practices
- Acknowledgement of Receipt of Notice of Privacy Practices
- Financial Policy Form
Bring the completed forms, your insurance card(s) and a method of payment for your co-pay and any past-due balances. If you are not insured, you will be required to pay for your visit in full before you leave the office, unless other arrangements have been made with the billing office. If you need to verify your insurance availability, click here to download an accepted insurance list.
We look forward to getting to know you and thank you for your cooperation. If you have any questions, please feel free to call our office.
The Staff at Summit Dermatology