your first visit
Welcome to ClearlyDerm Dermatology and thank you for allowing our team to care for you today.
During your first visit, in addition to the medical consultation, we will collect information on your medical history, current health and medical insurance. Please be sure to bring a photo ID and, if you have insurance, your insurance card.
For your convenience, we have made our patient registration forms available online so that you can fill out prior to your first appointment. If you are currently taking any medications, please have that list available when you fill out the form. It is important for us to know if you are taking any medication (e.g. heart medications, aspirin, anticoagulant therapy, etc.). Also, please tell us if you have any medical conditions (e.g diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.).
Please note: If you are under 18 years of age, a parent or guardian must accompany you to the consultation.
Our entire team at ClearlyDerm looks forward to providing you quality health care in a prompt, courteous and cost-effective manner.