FORMS

Prior to visiting to our office, you can help expedite your visit by printing the following forms and filling them out in their entirety. Please hand them to our staff when you sign in.

HIPAA Disclosure Form

Financial Responsibility Form

Patient Intake Form

Past History Form

RECORD RELEASE

If you would like a copy of your records, you can get them through your patient portal. If you do not have a printer there will be a charge of $10.00 for the first page and $0.50 per page thereafter, plus postage if you need them mailed.

INSURANCE

Please contact your insurance provider prior to your visit. We accept most insurances with the EXCEPTION of:

• AMERICHOICE

• CIGNA HMO

• HEALTHNET

• HORIZON HMO

• HORIZON MERCY

• HORIZON NJ HEALTH

• OXFORD LIBERTY

• UNIVERSITY H.P.

• AARP MEDICARE ADVANTAGE UNITED HEALTHCARE HMO

CARE CREDIT

We Now Offer Care Credit Financing with no interest for 6 months! Aesthetic Dermatology is both Top Rated and Flexible.

Cancellation Policy

We require 7 days notice for sugeries and 48 hours for all office visits.

$50 Cancellation Fee
$50 No Show Fee