Thank you for your confidence in Dermatology Surgery Center. We are committed to providing you with the highest standard of care before, during, and after your appointment. That is the reason for this page. The forms below are those we use to document your personal information before you see the dermatologist. Feel free to download the forms, fill them out, and bring them with you to your appointment. Please bring your insurance card along to your appointment. Patients under nineteen years of age need a parent or legal guardian to accompany them to their initial appointment.

Our skin is one of many integrated body systems. Skin changes can be related to problems with other body systems. Medicines, prescribed or not, taken internally (including aspirin, vitamins, supplements, etc.) or applied externally, impact the skin. Seemingly unrelated information, especially about medication, may be important to your diagnosis or safety.

That is why we believe a complete medical history is important. Below is a link to the medical history worksheet that we ask you to complete before you see the dermatologist. 

We will give you a confirmation call the day before your appointment. We look forward to seeing you! Please call us if we can answer any questions before then.

Sincerely,
David J. Watts, M.D.
Anthony J. Griess, M.D.

• Patient Demographics Sheet
• Medical History Worksheet 
• Medicare Secondary Payer Questionnaire (if applicable to your insurance)