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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Just a note to thank you for being so diligent in your pursuit of skin cancer. Because you caution 'on the safe side', you were able to detect my basal cell (carcinoma) very early. I also want to thank you for referring me to Dr.  Dhir. He was a dear! Thanks again for your care!

—ME
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I just wanted to drop you all a note to say thanks for the treatment I received in your office this week. I was very pleasantly surprised to have everything run as smooth as it did. Also, the follow-up call that evening was appreciated. You all are to be commended on your professionalism and concern.

—BW
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Thank you so very much for taking incredible care of my dad. I really appreciate it. I can't thank you enough for all you have done.

—SS
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Thank you so very much for the tender care given me for my surgery, and to call to check on me was so very thoughtful and kind. To check on me the night of surgery and then the next morning!! Thank you so very much.

—JS
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I appreciate your generosity in allowing me to observe you at work.  This was very educational, and now I feel I can properly inform patients about the expected experience when undergoing Mohs surgery.  It is clear to me what an elegant, accurate, and effective method to excising skin cancers.  I am impressed with the way your clinic is run.  The nurses and staff are very professional and responsive to the patients which I’m sure they appreciate.  I hope to see you in the future!

—ENT Resident
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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
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Words can never convey the depth of our gratitude in the treatment of our mother. Going the extra mile with follow-up phone calls and the prayers were greatly appreciated to relieve our fears and concerns. The kindness and compassion that was shown to her and even to us was so deeply felt. Thank you and your staff for everything.

—BB
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Thank you so much for taking extra time out of your busy schedule to give us answers to our questions and concerns. You treated us like how I wish all patients could be treated in the health care system today. Thank you for your wonderful handiwork. EH was in the best of hands.

—LH
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A royal thank you for treating me like a queen.

—EC