Patient Forms

Click on a link below to view and print available form(s). Bringing completed forms to your visit will reduce your wait time.

Forms updated September 23, 2017.

Thank you for choosing Alabama Dermatology Associates for your skin care. Please print and complete these forms prior to your first visit or if this is your first visit in one year or more.  Bring them with you to your appointment and present them to the receptionist.

Patient Information Forms

Please read the following notice and sign the Receipt of Notice of Privacy Practices.  Please bring the signed receipt to your appointment and present it to the receptionist.

Notice of Privacy Practices

Optional Forms

Laser Tech Form

Medical Release from Alabama Dermatology Associates

Medical Release to Alabama Dermatology Associates

 

If you have problems viewing the files linked above, you can download the free version of Acrobat Reader to view the files.