Forms & Policies

New Patients

Welcome to U.S. Dermatology Partners of Dallas – Uptown! Complete the forms in the new patient packet, listed below, and bring them to your initial appointment along with your photo ID, insurance card and credit or debit card (Visa, MasterCard or Discover).

New Patient Packet

  • New Patient Packet contains:
    • Patient Information
    • Acknowledgement of Office Policies
    • Patient Consents
    • Financial Policies
    • PHI Communication Preferences
    • Notice of Privacy Practices
    • Medical History
  • Minor Consent Form

If you have not completed the new patient packet, we ask that you arrive 10 minutes prior to your scheduled appointment time so that paperwork can be completed and we can get you checked in on time.

Minor Consent

If the patient is a minor (under 18 years of age), the parent or legal guardian must be present at the child’s initial visit to sign the parental consent form and provide the child’s social security number. The consent form you sign gives us permission to treat your child. Without a signed consent form, we cannot legally treat a minor child. At the initial visit, you can list other adults who can accompany your child to future visits.

If you are not the child’s parent but their legal guardian, you will need to bring legal documentation to confirm that you are the legal guardian. This information will be kept in the child’s file.

Established Patients

Please bring your photo ID and insurance card to each appointment.

Late Arrivals

We understand that sometimes you may be delayed. However, late arrivals may require rescheduling.

Insurance

We accept most major insurance carriers. Find the complete list of insurance carriers that we accept here. However, please contact your insurance company prior to scheduling your appointment to verify the specifics of your coverage. Also, it is important to ask your insurance carrier if any referral, pre-authorization or pre-certification is necessary before you schedule your appointment with us. HMO carriers require preauthorization prior to treatment.

Payment

Payment is due at the time services are rendered.

Medical Spa Guidelines:

At U.S. Dermatology Partners, we are dedicated to providing our patients high-quality, safe and effective care. In order to meet that standard we follow the guidelines set forth by the Texas Medical Board. Find a full explanation of the Texas State Medical Board Guidelines here.