If you are a new patient to Atlantic Dermatology, we thank you for choosing us. For your convenience, please find below two important forms we need to evaluate your past and current skin history, and to admit you into our dermatology clinic.
Instructions as follows; Print forms, hand-write information and bring to your appointment.
Medical Records Release Dermatology
Please call us at (757) 481-1666 if you have any questions about these forms, or if you need assistance.
“No-show policy: Scheduled appointments are considered a contract to reserve time with our physicians. Our office requires at least 24 hours prior notice if cancellation is necessary. Patients who do not keep their appointment and fail to notify us will be charged $50.00.
This will be the patient’s responsibility to pay, will not be billed to insurance, and will be due before future appointments can be scheduled.”