For Patients
NEW PATIENT FORMS
As a new patient to our clinic, we ask you to provide us with information about your medical history, insurance options, and contact information. We also ask that you acknowledge and accept our office policies. Below is the full list of forms you will need to complete, as well as additional forms you may have a need for.
In order for us to ensure our timely schedule and to make your experience at Arlington Center for Dermatology as enjoyable as possible, please have all of the necessary forms filled out and signed prior to your appointment. You can fill out, sign and submit forms on any computer or smartphone.
NEW PATIENT FORMS
Click on a Form below. Fill out the form, sign the form with your finger or using your mouse. Some forms have multiple pages; be sure to fill out second and third pages if a form has multiple pages. Once all pagers are filled out, click the SUBMIT button to automatically send your completed form to our offices. All information shared is encrypted and HIPAA secure. Be sure to complete all FIVE (5) NEW PATIENT FORMS.
ADDITIONAL FORMS
You only need to fill out these forms if requested specifically from our office staff. Text us at 817-755-5542 to see if you need to fill out any of these forms.
Associations
