Forms

Registration Form

New patients are encouraged to print and fill out a registration form.  Please bring this to your visit.

HIPAA NOTICE OF PRIVACY PRACTICES

Please read our notice of privacy practices that details how we may use your protected health information and your rights as a patient.

Records Transfer Request

In order to have your prior biopsy results or treatment records sent to our office, please fill out the above form and provide it to your physician.

Dry Skin Care

Recommendations for the treatment and prevention of dry skin.

Retinoid Application

Most acne medications will cause dryness and irritation of the skin.  The above form outlines some tricks to prevent this unwanted effect.  This is key to getting you through the first few weeks of a new treatment and on the path to clear skin.

Instructions for use the of Benzoyl Peroxide Products for Acne

Reference this document for the proper use of benzoyl peroxide in the treatment of acne.

Cantharidin for the Treatment of Molluscum Contagiosum

“Blister beetle juice” for the treatment of warts caused by the molluscum contagiosum virus.

Cryosurgery

Refer to this information sheet if you had treatment with liquid nitrogen.

Instructions for the use of 5 – Fluorouracil

This form serves as a guide to treatment of actinic keratotis with 5 – Fluorouracil.

Treatment of Scabies with Permethrin

This form provides details on how to use permethrin and other means to eradicate scabies.

Wound Care – General

This describes how to care for your wounds following routine procedures such as biopsies or incision and drainage of boils and infected cysts.

Wound Care Instructions for Sutured Wounds

See the above for the post-operative care of sutured wounds including those following excisions and Mohs surgery.

Wound Care Instructions for Granulating Wounds

Granulating wounds are those which are left to heal on their own without the use of stitches.

Wound Care for Skin Grafts

When a skin graft has been placed follow the above instructions.