Patient Forms


New Patients


In an effort to serve you better, we ask that new patients arrive 30 minutes prior to their scheduled appointment time. This time is necessary to allow for new patient registration. If you have all of the paper work filled out completely then you may arrive 15 minutes before your scheduled appointment. Upon arriving to you appointment you will need to bring a picture ID, insurance card, a list of medications and a referral if your insurance requires it. It is the patients responsibility to obtain a referral from their primary care physician.

DOWNLOAD NEW PATIENT FORM 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