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Patient Forms

If you are a new patient and currently have an appointment scheduled with us, please feel free to download the following forms.

To save time, these can be printed and filled out prior to your arrival.

Please bring them with you to your visit and hand it to our receptionist when you first check-in.

General Dermatology Appointment Forms

New Patient Information and History Form (Contact to receive form)
Notice of Privacy Practices
Minor Consent Form
Records Release Form*

*The Records Release Form is only used to release records from an outside office to be sent to Dermatology Consultants of Frisco/Precision Dermatology. If you need a form to get our records, please call our office.

Cosmetic Appointment Forms
Cosmetic Patient Information and History Form Download PDF
*Cosmetic consultations and services are not covered by insurance.

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Patient Forms

Dermatology Consultants of Frisco

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