Thank you for being our patient.

We are honored you have selected Advanced Dermatology & Skin Cancer Center, PLLC to be the dermatology provider for you and your family.

The following patient forms can be downloaded and printed at home. By filling out these forms ahead of time, you will save time during your visit. Please be prepared to provide this forms to our office along with your current medical insurance information and identification. If you have any questions when filling out these forms, our staff can assist you with your questions on the day of your appointment.

If you are a new patient, please print and complete the forms below to bring to your appointment:

HIPAA and Financial Consent Form
New Patient Forms

Advanced Dermatology & Skin Cancer Center, PLLC is dedicated to providing the highest quality care for our patients in a timely and efficient manner. In an effort to maintain that efficiency, we attempt to contact every patient at least 24 hours prior to their appointment as a courtesy reminder. However, it is the responsibility of the patient to arrive on time for their appointment.

We understand that appointment cancellations are sometimes necessary. If you are unable to keep your appointment, our cancellation policy asks that you please call our office at least 24 hours in advance for regular appointments, and 48 hours in advance for surgical and cosmetic appointments. This allows us to offer your appointment to other patients who are seeking medical treatment.

Patients that do not call at least 24 hours prior to missing a regular appointment will be charged a $35 “no-show” fee. Patients that do not call at least 48 hours in advance for surgical or cosmetic appointments will be charged a $100 “no show” fee.

Advanced Dermatology & Skin Cancer Center, PLLC, downloadable policy documents:

ADSCC Financial Policy

ADSCC Notice of Privacy

Online Bill Pay

For your convenience, we also offer online bill pay. Please enter the amount you wish to pay in the box below and click “Click to Proceed” to go to the next step. In the next step, you will enter your account number and additional information.
Thank you for your payment.

Once you enter the amount you wish to pay, click the button “CLICK TO PROCEED” to be redirected to our payment processing page to complete the transaction and ensure it is properly attached to your account.
*NOTE: You will enter your account number in the “Invoice” field on the payment processing page.