Advanced Dermatology Northwest
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New Patients

Please check the list of contracted insurance carriers below or call our office if you have any question about whether we accept your insurance.

We take the following insurance:

You can bring completed patient forms to your first visit. You can also enter or update your contact information, medication list, allergies, past medical history, and pharmacy information through the Patient Portal. You may ask for your user name and password from our office.

           

Please read our Notice of Privacy Practices, which is standard patient privacy information. Then, print and complete the ONE Patient Registration Form that is appropriate for you. Finally, please print, read, and sign our Office Financial Policy.

You can download the Acrobat Reader if necessary.

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Read-only
Notice of Privacy Practices
This document is read-only.
Read and sign
Office Financial Policy
Choose and complete ONE of these
Minor Patient Registration Form
All patients under 18, or over 18 if still on parents' insurance.
Adult Patient Registration Form
Patients over 18 and insured by self, spouse, or partner.
Medicare Patient Registration Form
Patients over 65 who have Medicare Part B coverage.
Complete this
Patient Health History Form
Health history quesionnaire for patient exam.

Your appointment:

Please be on time for your appointment, and arrive 15 minutes early if you will be completing forms in the office. We reserve the right of charging a $50 fee for appointments cancelled within less than 24 hours of the scheduled date and time.