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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Everyone was extremely pleasant and helpful. All procedures were explained in detail which made the experience comforting. This is a wonderful group.

—Anonymous
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Dr. Dhir, you have a special gift that I'm blessed to have been a recipient of, and I want to thank you from the bottom of my heart for what you do and I hope you'll be around a long time to share that gift.

—NH
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It is a miracle to look at Gordon and not see the large, red, and very irritating sores that were there. Dr. Dhir did the surgeries…I thank God and Dr. Dhir and his assistants for their most patient, kind, and loving treatment of Gordon. He is a special person and I know God has helped us to get this far with his recovery from a most dramatic period in his life.

—The Central Record (newspaper column), October 26, 2006
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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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AT is doing fine. I just wanted to thank you for all your kindness. You were super in my eyes. We will never forget you all. God Bless you all.

—OT
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I just wanted to tell you again what a wonderful job you did on my face. As you said it would, each month it gets better and better. If you did not know me, you would never notice it. I am sending this picture so you can see for yourself. Maybe you can put in my file next to the ones that I look beat up in. Ha. Anyway, I really appreciate all of you, not only the great work you do but the care and kindness you showed me. It meant more than you will ever know. Love,

—KL
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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)
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Not only were the staff very kind and caring, but are a real credit to their profession. I was very impressed with the way they relate to their patients. Thank you for taking the time to explain everything to us. Your staff is very wonderful. You should be very proud of them.

—HH
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