Patient Registration & Forms
FIRST, please complete/update your information on our Patient Portal. If you need log-in assistance, please call us so we can help you.
New Patients: please click on the applicable option below to complete your registration paperwork.
Established Patients: please click on the link below to complete your registration paperwork.
At each visit, please bring a current list of any medications you are taking, including the name, dose, and route of administration.
For helpful video instructions on how to register for our patient portal, complete your consent forms, and upload a photo, please visit our website: How To Videos for Our Patients.
For your convenience, here are frequently requested forms, authorizations, and helpful information.
- Medical Records Request Form (complete via secure portal)
- Authorization for Release of Medical Records (complete via secure portal)
- Authorization to Treat Minor (complete via secure portal)
- Authorization/Revocation for Release of PHI (complete via secure portal)
- Preparing for Mohs Surgery (Download)
To facilitate referral coordination, please ask your referring provider to complete our fax cover sheet and fax the requested information to our office at (303) 761-0907.
For downloadable and fillable PDFs of the forms above, please click here.
On the day you visit our Denver area dermatology and Mohs surgery practice for your appointment please bring your insurance card. Be sure that any required referral has been processed. Insurance co-pays are expected to be paid at the time of your visit.
We accept most major insurance carriers (including, but not limited to, Aetna, All Savers, Anthem Blue Cross/Blue Shield, Banner Health, Beech Street, Bright Health, Cigna, Clear Spring, Cofinity, Coventry First Health, Denver Health, Friday Health Plans (f/k/a Colorado Choice Health Plans), GEHA, Golden Rule, Health Partners, Humana, Kaiser (Denver/Boulder Members Only, Referral Required), Medicare, Medicare Complete (AARP, Aetna, BCBS, Cigna Healthspring, Clear Spring Health, Humana), Multiplan Network, Oscar, PHCS Network, Rocky Mountain Health Plans, Tricare, TriWest, United Healthcare & VA). Please call your insurance provider prior to your first appointment to confirm that we participate in your insurance plan.
Please be aware of your individual deductibles, co-pay and co-insurance amounts. Insurance coverage does not guarantee insurance payment.
You will receive a statement that lists any unmet deductibles, co-pay and co-insurance amounts due after your insurance has paid the portion covered by your plan. Prompt payment is appreciated.
Often procedures require a prior authorization (PA) from your insurance company. Our office will assist in obtaining this authorization from your insurance company prior to your procedural visit. This requires substantial work and may be a lengthy process, so please do not hesitate to contact our office to check your prior authorization status.
Cosmetic treatments are out of pocket non-insured billable expenses. A cosmetic consultation will enable you to determine the best treatment plan for you.