Patient Forms

The forms that must be filled out are the Patient Information Form, Medical Questionnaire, General Consent Form, Financial Policy Form, and Minor Consent Form. The others as needed.

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Required Patient Paperwork

Please complete the below forms 48 hours before your appointment

asteriskPatient Information Form (use Google Chrome or Firefox Web Browsers)
asteriskMedical Questionnaire
asteriskGeneral Consent Form
asteriskFinancial Policy
asteriskNotice of Privacy Practices (please read-Rev. 9-23-14)
asteriskInsurance Card
asteriskDriver’s License

Optional Forms

If you have a minor patient that will be attending appointments alone or with an adult that is not the guardian Please complete the Minor Consent Form here:

asteriskMinor Consent Form

If you would like us to request records from another practice, or wish for us to send your records to another practice please complete the Medical Release Form here:

asteriskAuthorization for Release of Medical Information

Dermatology is not preventative care. For more information see this form:

asteriskPreventative Care and Dermatology Letter

 

 

 

 

Our Locations

North Atlanta Dermatology has five locations around Northern Atlanta to serve you.

Duluth Office

3850 Pleasant Hill Road
Duluth, Georgia 30096

Suwanee Office

3370 Paddocks Pkwy.
Suwanee, GA 30024

Hamilton Office

3331 Hamilton Mill, Suite 1106
Buford, GA 30519

Cumming Office

1230 Bald Ridge Marina Rd., Suite 300
Cumming, GA 30041

Marietta Office

1519 Johnson Ferry Road, Suite 175
Marietta, GA 30062

Our Locations