Patient Forms

We look forward to taking great care of you.

Patient Forms and Resources

If you prefer not to use the electronic Patient Portal, you may download and complete selected forms by hand and return them to us via email, fax, or in person.

Patient Portal Guide
Preparing for Surgery (Preoperative Instructions)
After Surgery
Medical History Form
Financial and Privacy Policy Acknowledgement
Release of Medical Records
Privacy Practices
Non-Discrimination Policy

Information You Can Trust

Learn About Skin Cancer

Skin Cancer Support

See What Our Clients Are Saying

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Dr. Dhir and Jackie, I am blessed to have you be my Mohs team!  Thank you!

—DF
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Thank you for the opportunity to spend time in your practice learning about Mohs surgery and more particularly the art of reconstruction. I sincerely appreciate that you tailored your teaching to my future plans. You are the only professor to have done that so far. This week has given me a great deal of insight into future standards for appropriate skin cancer treatment and management. I look forward to a day when I will be honored to call you a colleague.

—MN, Medical Student
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I feel like the luckiest person on earth that I was sent to you.  You have the lightest touch while working, but the determination to get things right like a 5 Star General.  You are rare.

—JM
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Thank you for your kindness. I wish I could put into words what your thoughtfulness means to us. I am so amazed at the things you have done for my husband and myself that you didn't have to do. It is very greatly appreciated.

—JE
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I wanted to say thank you to you & your staff for the successful removal of the BCC from my forehead.  The wound healed nicely & is not noticeable.  I appreciated how you shared in advance the details on how you perform Mohs surgery.  I enjoyed you sharing your interest in sports cars and racing.

—BB
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I want to thank you for your superb professionalism, kindness, and huge heart.  You made my experience through the Mohs Surgery bearable, you explained in detail what to expect, and you calmed my racing heart. It took 3 attempts to achieve clear margins and while I was waiting, the staff was nothing but excellent, caring, and reassuring.  You have an A Class Facility.

—NH
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Thank you for all your care and concern and all your patience and time you used on me. You and your staff were wonderful. God bless you.

—DC
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Thank you for the wonderful care you provided for me in the past weeks. I so appreciate you and value your friendship of the many past years. You are truly a great professional who's caring and skills is beyond compare.

—C
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Thank you for making my unpleasant situation less stressful and not so unpleasant. God Bless You!

—SM