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Patient Forms

For your convenience, you can now complete your New Patient forms online! When you complete your new patient forms online, we will have you registered in our system by the time you arrive for your appointment, making your appointment much smoother, faster and more efficient.

In order to take advantage of this option, you must first create an account with a personal user name and password, which are just for your use, and enter some personal information to verify who you are.  Any information you provide can be entered with confidence because it will be processed securely.  Also, all of the information you enter to register will be automatically copied into your New Patient Demographic form.  The entire process should take 5-10 minutes. Click Here to get started setting up your account!

Once you have set up your account, you should click on the link to "Health Forms" and follow the directions there to fill in and submit your forms.  Be sure to fill in your insurance information and complete all four steps of the process.  Becoming a memeber of our virtual office through this simple process does not establish a doctor/patient relationship, but will make your visit to our office more concise and enjoyable. 

Another option is to download and print the forms found below.  You can then complete them and fax them to us prior to your appointment, at 919/782-7929, or bring them with you when you come for your appointment. 

We hope these convenient options for working with us will improve your experience here. Thank you for choosing The Dermatology & Skin Cancer Center.

Patient Information Form   Download
Medical History Form   Download
Request to Transfer Medical Records to Our Practice   Download

Request for Medical Information (to self or other provider)   Download

HIPAA Policy
Financial Policy
New Patient Registration

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