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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The care that you and your staff showed me when I had my nose surgery was phenomenal!! I have never been to a doctor's office that showed so much compassion for his patient and your staff was fantastic, too!

—ML
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Just wanted to drop you a note to let you know that I'm very pleased with the outcome and appreciative of your superb skill as a surgeon.

—SP
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Thank you for allowing me to observe your surgeries and 'talking shop' through the procedures for my benefit. Your sincere concern for your patients' comfort, as exhibited by your extraordinary bedside manner, truly sets a new, higher level for me to strive toward. I will strive for the highest mark, and I appreciate your example and training.

—TB, Medical Student
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I wanted to thank you and your staff for taking such good care of me when I visited the surgery center. I was happy to be treated so kindly and really appreciate that your nurses went out of their way to make me comfortable and help accommodate me with my modesty / religious preferences. Thank you.

—A
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Dr. Dhir, Wanted to show my appreciation for the excellent care I received last month!  Thank you so much!!!

—JS
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You pros did a dandy job on my surgery this month:  no pain, no bleeding, no scar, no bad news. :-)

—TK
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Thank you for the Dermabrasion. My nose looks 100% better. You are the BEST doctor I know, and Theresa you are by far the best nurse I ever seen. Thank you for being so thoughtful and making me feel special. I just can't say enough about you two.  Thank you.

—TD (following Mohs surgery for facial skin cancer and dermabrasion of nose)
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Just a brief note to express my satisfaction with the outcome of the surgery thus far. I appreciated you taking time out of your busy schedule to answer my questions. Also, I want to compliment your staff because they're so courteous whenever I call and they're so helpful. I recommended you highly to a friend who is now considering surgery on her face. She sees a doctor at UK but I said she should consider using your services. In short, I'm glad I put my face in your hands.

—CS