- First Time Visit
- Accepted Insurance
- Changes or Cancellations
- Preparing for Your Cosmetic Consult
- Cosmetic Surgery Procedure Policy
- Patient Forms
- Patient Portal
FIRST TIME VISIT
- Our office hours are 8:00am – 5:00pm Monday – Friday
- New patients should arrive 30 minutes early to fill out paperwork.
- Please bring all your medications and information on pertinent past medical history, if possible.
- Please try to put 2 hours on the parking meters (most affordable parking lot is between Davidson & F St on Landis Avenue for 25 cents per hour).
- Full body exams can be time consuming and often times we cannot perform procedures in addition to a full body skin cancer screening (although this is patient and case dependent). Please notify our staff in advance if the purpose of your visit is for a full body exam.
We accept the following insurance plans:
- Blue Cross and Blue Shield
- Most PPO private health insurance plans
- Mercy is the only HMO plan accepted
CHANGES OR CANCELLATIONS
Please be aware that our office charges a fee for missed appointments or cancellations less than 24 hours. For a medical appointment a fee may be added to your account if appointment is not cancelled within 24 hours of a scheduled time.
Please be advised if you cancel less than 48 hours of your scheduled time we reserve the right to keep your deposit or you may be billed a $100 fee for cosmetic appointments.
PREPARING FOR YOUR COSMETIC CONSULT
Cosmetic consults have a $50 nonrefundable fee that does not go toward any procedure that day. The consult includes a picture taken by VISIA camera which is a complexion analysis report giving comparative percentile scores for your age group of your spots, wrinkles, texture, pores, UV spots, and porphyrins. There will also be a skin care regimen that will be discussed at the consult as well as recommendations of cosmetic procedures.
New patients should arrive about 30 minutes early to fill out paperwork and begin the VISIA camera analysis.
WHAT ARE MY GOALS?
What would you most like to change? Bring a flattering photograph of yourself from five or ten years ago, if you like.
WHAT IS MY BUDGET?
Figure out the amount you’re prepared to spend, and do your homework on the current costs of various procedures. Once you decide on a potential course of action, ask your doctor if it’s realistic to accomplish it on your budget.
WHAT ARE MY EXPECTATIONS?
It’s important to understand the limitations of what these procedures can do. Our goal is to capture your own individual beauty and enhance it in subtle ways, to make you look fresher and more youthful — not to completely change your face.
WHAT ARE MY FEARS?
Your fears probably fall into three categories of a frozen expressionless face, large duck lips, and pain. We don’t like that either and part of our role as dermatologists is to act as a voice of reason, advising patients when to back off and do less in order to achieve natural-looking results.
COSMETIC SURGERY PROCEDURE POLICY
Our office policy is to ask patients to pay half of the total cosmetic fee (for procedures that cost over $500) as a down payment to reserve the procedure date. The remaining balance is due 2 weeks prior to the procedure. If we have not received full payment 2 weeks prior to the procedure date, the appointment will be cancelled.
If you must reschedule or cancel a surgical procedure, at least one-week notice is required. If one week notice is not given half of the procedure fee will be retained. It is your responsibility to document the date, time, and the name of our office staff member who received the notice of cancellation. A physician must confirm last minute cancellations, due to illness, in writing.
Once your initial down payment is made, your procedure date and time will be scheduled. We will reserve the operating room, schedule the nurse (if necessary), and prepare the several documents that are required. If the procedure is canceled more than one-week in advance and not rescheduled, we reserve the right to charge an office charge of $100 and any additional overhead expenses.
Our staff routinely telephones patients two to three days before surgery. If we are unable to reach you, we would kindly appreciate you telephoning us 24-48 hours prior to your surgery to confirm your scheduled procedure. Thank you for your understanding in this matter.
The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current medical insurance information.
- Patient Cosmetics Questionnaire
- Patient Medical Questionnaire
- Cuestionario Medico
- Forma de Nuevo Paciente
- New Patient Form
- Medical History
- Historial Medico
- Financial Policy
- Physician-Patient Arbitration Agreement
You have been given your unique User Name and Password as your “Sign In” and you will enter these on the Log In box. You will also be able to enter pharmacy data as well as fill in 1) Past Medical History; 2) Skin Disease History; 3) Medications; 4) Allergies and Social History and any other information you will need to provide the practice.
NONDISCRIMINATION AND ACCESSIBILITY REQUIREMENTS
Dermatology Institute complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Dermatology Institute does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
Provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you believe that Dermatology Institute has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.