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Patient Forms


 

New Patients


All new patients are required to pre-register one week prior to their appointment via email, completing in the office or turning in the completed downloaded paper work. Picture ID, insurance cards, and referral if your insurance requires it till also need to be turned in before the appointment. Failure to complete the forms and turn them in on time will result in appointment cancellation.

In an effort to serve you better, we ask that you please arrive 10 minutes before your scheduled appointment time.

DOWNLOAD MEDICARE INSURANCE FORMS HERE

DOWNLOAD COMMERCIAL INSURANCE FORMS HERE


Lab-Work or Biopsies


Regardless of your insurance, if you require lab-work during your visit, you will receive a bill from the laboratory where you get your lab-work drawn. If you require a biopsy during your visit, there will be a separate bill both for the lab that processes the biopsy and the physician who reads the biopsy.


Payment


We accept Master Card, Visa, Discover, cash, and checks. Payment is due at the time of service. All cosmetic consultation and procedure fees must be paid in full before the consult or procedure is performed. We do not bill or accept payment from insurance companies for cosmetic procedures.


Cancellations


As a courtesy to all of our patients, we ask that all cancellations be made at least 24 hours in advance of the scheduled appointment time. Failure to comply with this request will lead to a $50 “No Show” fee for the day of that appointment. This will be billed directly to the patient and not to the insurance company. We ask that follow-up patients arrive for their appointments on time. If you are late, we will make every effort to see you the same day. However, you may be asked to reschedule if the doctor’s schedule is full.

 

Location

Integrated Dermatology of Yuma
2500 South 8th Ave., Suite 101
Yuma, AZ 85364
Phone: 928-788-0785
Fax: 928-783-0634

Office Hours

Get in touch

928-788-0785