Patient Information

We Value Our Patients

Here at Dermatology Associates, we really do value each and every patient. Your concerns are important to us. We hope you find our site helpful and informative. If there is any topic you'd like to see us cover here, please let us know.

Patient Forms

We know your time is valuable. That's why we offer PATIENT FORMS online. Whether you are a new patient or a current patient who needs to update information, just click on the links below and fill in the text fields on-screen. Then simply PRINT and bring the forms with you to your appointment. Be sure to print a copy for your home records too.

NEW PATIENT REGISTRATION FORM
NEW PATIENT HEALTH HISTORY FORM
PATIENT HEALTH HISTORY–UPDATE
NOTICE OF PRIVACY PRACTICES (HIPAA)
CREDIT CARD AUTHORIZATION

PAYMENT POLICY (2 pages)

MOHS PATIENT INFORMATION FORM & Payment Authorization
(For Mohs patients only)

"Filling out the patient forms online before my appointment is a great idea! It gave me time to think and answer the questions accurately."

 

Accepted Insurances

Dermatology Associates at Crystal Run accepts most insurances. Here are a few of the top insurances we accept.

  • EMPIRE BC/BS
  • EMBLEM GHI / EMBLEM HIP
  • EMPIRE NYS
  • MVP INSURANCE
  • AETNA
  • MEDICARE
  • CDPHP

Please call our office if your insurance is not listed here to confirm that we accept your plan. As much as we try to keep information on this site up-to-date, there may be times when companies are added to the list or removed without notice. We appreciate your understanding.

 

 

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