Patient Forms


New Patients

Your visit to Spectrum Dermatology involves information so that we can get to know you. We will be sending an email to all new patients with all the necessary paperwork to be completed and brought in to their first appointment. Below are our Online Forms that can be completed, printed and signed, if this is more convenient. These forms will need to be faxed, uploaded to your patient portal, or brought in at your appointment. 

History and Intake Form
Download
Financial Policy
Download
Privacy and HIPAA
Download
Patient Information Form
Download
Notice of Privacy Practices
Download
Credit Card on File Policy
Download

Other Forms

Advanced Consent to Treat a Minor Patient
Download
Patient Health Information Release
Download
Parental Consent for Portal Access
Download
Vulvar Symptom Questionnaire
Download
American Academy of DermatologyAmerican Board of DermatologyAmerican Medical AssociationThe International Society For The Study Of Vulvovaginal DiseaseNational Vulvodynia AssociationWashington Dermatology AssociationWomen's Dermatologic Society
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