For Patients > New Patients / Info
Email:
info@ADCderm.com
info@ADCderm.com
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Wireless Internet available at White Bear Lake & Stillwater
ADC accepts the following:
First Appointment
To help us serve you better, please arrive 10 minutes prior to your appointment and bring the following items:
By filling out your Patient Medical History Form ahead of time, you will save a significant amount of time during your visit. If you prefer to complete your patient forms in our office, please arrive 15 minutes before your appointment.
Please be prepared to provide this information to our office along with your current medical insurance information. If you have any questions when filling out these forms, please bring them with you on the day of your visit and our staff will assist you.
Patient Medical History
Cosmetic Consultation Form
HIPAA Authorization
HIPAA Information (Health Insurance Portability Accountability Act of 1996)
Authorization to Release Protected Health Information
Provider Referral
If you have been referred to Advanced Dermatology Care for a consultation from your provider please bring a note from your provider and any records regarding the medical concern.
Fees / Payments
Fees for co-payments, cosmetic services, and private insurance are collected at the time of your visit.
Important Information Regarding Minors
Any Child or young adult less than 18 years of age must have a parent or legal guardian present with them for the initial visit and any subsequent visits requiring a procedure not previously performed at ADC
Additional Patient Information
Need Adobe Acrobat Reader?
Patient Forms are provided in a .pdf format. You will need Adobe Acrobat Reader to open and print these forms. If you do not have a copy of Acrobat Reader, you can get a free download by clicking on this Acrobat Reader link.
To help us serve you better, please arrive 10 minutes prior to your appointment and bring the following items:
- Insurance card
- Copay
- Current Medications
- Insurance referral (if needed by your Health Insurance plan)
By filling out your Patient Medical History Form ahead of time, you will save a significant amount of time during your visit. If you prefer to complete your patient forms in our office, please arrive 15 minutes before your appointment.
Please be prepared to provide this information to our office along with your current medical insurance information. If you have any questions when filling out these forms, please bring them with you on the day of your visit and our staff will assist you.
Patient Medical History
Cosmetic Consultation Form
HIPAA Authorization
HIPAA Information (Health Insurance Portability Accountability Act of 1996)
Authorization to Release Protected Health Information
Provider Referral
If you have been referred to Advanced Dermatology Care for a consultation from your provider please bring a note from your provider and any records regarding the medical concern.
Fees / Payments
Fees for co-payments, cosmetic services, and private insurance are collected at the time of your visit.
Important Information Regarding Minors
Any Child or young adult less than 18 years of age must have a parent or legal guardian present with them for the initial visit and any subsequent visits requiring a procedure not previously performed at ADC
Additional Patient Information
Need Adobe Acrobat Reader?
Patient Forms are provided in a .pdf format. You will need Adobe Acrobat Reader to open and print these forms. If you do not have a copy of Acrobat Reader, you can get a free download by clicking on this Acrobat Reader link.