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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Thank you for the opportunity to work here and all that I have learned. Thank you for always standing up for what is right and for always defending the employees. I appreciate that very much! I wish you all the best!

—MS
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This older man greatly appreciates your excellent care and kind attention. Thank you so much.

—J
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Three days have passed since your removal of the cancer from my face.  The pain from the surgery has been light and tolerable.  There has been no need for pills to relieve this pain.  There are no signs of bleeding or of swelling.  You mentioned the danger to a nerve which controls the mouth, had the cancer not been removed.  The body is wonderfully made!  It has never occurred to me that there is a mechanism which enables us to open our mouths.

—W
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Thank you for doing a great job on getting cancer off my eyelid and out the corner of my eye. It has healed well! Every one of you in the office treated me well and took good care of me and I really appreciate that. I'm very pleased that my eye is alright and I hope you can see how is has healed. Thank you so very much!

—RM
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Thank you all for being so kind, compassionate, and caring.

—PR
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Thank you for all your kind service, your happy smiles and care.  Enjoy the sweets that are as sweet as all of you. 

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

—DF
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I guess that is what makes your so special. And for all the phone calls you have made, checking on me after surgeries, that means the world to me. I just hope you and your staff realize how special you are to me and my family. Without you, this journey might not have lasted this long. Thanks for everything in helping me fight this disease.

—PE (after four years of multiple Mohs surgeries for organ transplant-related skin cancers)