New Patient Forms & Privacy Policy

 

Please click on the links below to access our new patient Medical History and HIPAA Release forms.  Print out both forms, fill outappropriate information, and present both to reception staff when you arrive for your first visit.


Medical History Form

Medical History Form – Drug List Additional Sheet (Optional As Needed)

Authorization for Release of Information (HIPAA)

Please note:  If you already have a handwritten or typed medication list, you may write “see attached” in the medication list section of the medical history form, and then bring your existing medication list along with the above forms to our office.

Privacy Policy

You may also download and review a copy of our “Notice of Privacy Practices” at the link below.

HIPAA Notice of Privacy Practices

For more information on our new patient policies or skin tightening in St. Louis please contact us!

Types of Payment Accepted

Payment for services is expected at the time services are rendered.  We offer several payment options. In addition to check or cash we also accept MasterCard, Visa and Discover. Most major insurance plans accepted for medical dermatology procedures.

We also accept Care Credit.


If your insurance plan requires a referral to a dermatologist, please see your primary care physician first.

Read more

 

The PrecisionTx laser enables minimally invasive treatment of smaller areas.

  Treatment areas include the neck and jawline as well as ablation of axillary sweat glands to treat Hyperhidrosis.

Read more