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Patient Information / Forms
Thank you for choosing Town Center Dermatology for your skin care needs.
The following tips will make your apppointment flow more smoothly and minimize any delays
on the day of your visit.
New patients:
Please arrive 15 minutes prior to your appointment. Please bring the following items on the day of your visit:
- Photo ID (ie.Drivers License)
- Insurance Card(s)
- New Patient medical history forms (see below)
If you are a new patient, please print and fill out the medical history forms located under "Forms" at the bottom of the page.
Co-Pays:
If your insurance requires you to pay a co-pay for your office visit, this will be collected at the time of service. Our office will file insurance claims only for those plans in which the doctor participates(see list of
Major Insurances Accepted). We will provide a receipt for you to submit to any plans in which we do not participate, in order to you to be reimbursed. Cosmetic services cannot be submitted to insurance and payment in full is expected at the time of service. Acceptable forms of payment are cash, personal check or credit card (Visa, Mastercard, Discover).
Late Notice:
*If you anticipate being more than 15 minutes late to your appointment, please call to notify the office. We will make every effort to accomodate you, but to be fair to all patients we may have to reschedule your appointment.*
Patient Forms
All forms are in pdf format. Download a free pdf viewer
here.
Patient medical history forms for new patients to fill out and bring to initial visit (2 pages).
If you would like to have your old medical records (office notes, biopsy reports) sent to Dr. Kling, please print this
release form, fill out the pertinent info, sign and give or fax to your previous provider.
Notice of Privacy Practices
Non-Discrimination Policy
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Copyright © 2009-2022 Town Center Dermatology, All rights reserved.
Site design & host: NeuronLinks, Inc.
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