Patient Forms

If you are coming in for an initial consultation, you can save time by filling out the required forms ahead of time. You can do this online or print them using the buttons below.

The forms work best when filled out on line as this step will save you time from needing to wait in the office for the data to be typed in to your chart. Please follow the link below containing our patient intake required questionnaire. After calling our office at 702-456-3120 for your patient log in code, you will be able to fill out all required fields prior to your first visit. Once the computer work has been completed, be sure to click “Finalize” and simply log out.

CLICK HERE TO CREATE AN ACCOUNT OR LOG IN

If you are unable to fill out the paperwork on line, you may need to come in earlier for your appointment, as we will need time to input your information into our electronic record. Please print your forms using the button below and fill out the forms prior to your arrival.

CLICK HERE TO VIEW, DOWNLOAD AND PRINT THE FORMS
Las Vegas Dermatology for a healthier and beautiful life

Contact us today to schedule your consultation.

653 North Town Center Drive, Suite #414
Las Vegas NV, 89144 USA

Tel: (702) 456-3120
Fax: (702) 823-1069

Office Hours:

Monday – 8am – 5pm
Tuesday – 8am – 5pm
Wednesday – 8am – 5:30pm
Thursday – 8am – 5pm
Friday – 8am – 4:30pm