Medical Forms

Patient Resources

To streamline your check-in time we’ve assembled a list of commonly used forms and resources for you to download and fill out prior to your visit. The links below will give you access to almost everything you need to be well-prepared and well-informed about your appointment at Integrated Dermatology of Tidewater.

Account and Billing Information

Medical Dermatology Forms and Information:

• HIPPA Consent Form
• Medical Records Release Form
• Patient Financial Responsibility Form
• Patient Medical History Form
• Contact Preferences Form
• Registration Form

Cosmetic Forms and Information:

• New Cosmetic Patient Registration Form - Aesthetics
• New Cosmetic Patient Registration Form - Injectables

Surgical Patients:

• Excision Consent Form
• Wound Care Instructions PDF

MOHS Patients:

• MOHS Consent Forms
• Wound Care Instructions PDF

Clinical Appointments and New Patients

Please print and fill out forms to bring with you to your appointment arriving 15-minutes prior to scheduled time.  If unable, please arrive 30-minutes to process required forms. 

24-hours notice is required for an appointment cancellation and/or a reschedule. Our medical team manages the provider and patient schedule. Any delay in arrival will reflect the start of your appointment. 

Learn more about our exclusive services 

• Aesthetic Skin Care
• Tidewater Medical Spa
• Mohs Procedure
• Saturday Clinic
• Dermatologic and Surgical Care

Treat your Concerns with Us ~ Request an Appointment