Registration Forms – Family Dermatology

Online payments are available please click on this link to pay your bill online.

Family Dermatology is pleased to welcome Taylor Zuber, MD to our practice. Dr. Zuber joined our practice on September 1, 2023. To learn more about Dr. Zuber click on the link. She is accepting new patients. Please call our office to schedule.

Family Dermatology is pleased to welcome Jennifer Adair, Physician Assistant to our practice. To learn more about Jennifer, click on the link. She is accepting new patients. Please call our office to schedule.

Registration Forms

March 6, 2017September 15, 2023 Danieljfaucette
  • New Patient History
  • New Patient History (Word doc)
  • Telemedicine Consent (pdf)
  • Telemedicine Consent (Word doc)
  • Medical Records Release
  • Consent for Treatment of Minors

Registration Forms

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Patient Information →

Registration Forms

  • New Patient History
  • New Patient History (Word doc)
  • Telemedicine Consent (pdf)
  • Telemedicine Consent (Word doc)
  • Medical Records Release
  • Consent for Treatment of Minors

Patient Information

  • Privacy Policy
  • Pre-op Instructions
  • Post-op Instructions
  • Financial Policy
  • Financial Policy (Español)
  • HIPAA policy (text and email)
  • HIPAA policy (text and email – Español)
  • Nondiscrimination Policy
  • Medication list
  • Disabled Patients Policy (Coming Soon)

Other

  • Cosmetics
  • Make a Payment

Phone: 919-791-0840

Fax: 919-791-0911

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