Forms & Policies
Welcome to Medical Dermatology Specialists Phoenix, now a part of U.S. Dermatology Partners! Complete the forms 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).
Please review the following handouts if you are scheduled to receive an operation or Moh’s surgery:
Please bring your photo ID and insurance card to each appointment.
We understand that sometimes you may be delayed. However, late arrivals may require rescheduling.
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 is due at the time services are rendered.
You have the right:
- To be treated with respect and dignity.
- To receive information about your care, in ways that you can understand.
- To receive emotional support from the staff.
- To participate in decisions regarding your care and treatment.
- To receive privacy for treatment and to expect that information regarding your case will be kept private.
- To have a family member stay with you during your visit.
- To be cared for by doctors and others who know how to care for children and teenagers.
- To know the names of the people caring for you.
- To be taught, in ways that you can understand, how to take care of yourself at home.
- To receive language assistance services, if required, to communicate to office staff.
- To a sign language interpreter if one is required for you to effectively communicate with the staff.
- To receive information about pain and pain relief measures.
- To have health professionals who respond quickly to your reports of pain.
You have the responsibility:
- To tell the doctors how you are feeling.
- To tell the doctors when you do not understand something that they are doing or saying.
- To follow your plan of care as you agreed to do.
- To respect the rights and privacy of other patients and their families.
- To treat the staff with respect and dignity.
- To ask your doctor what to expect regarding your pain and pain management.
- To help your doctor assess your pain and discuss pain relief options.
- To tell your doctor about any worries you have about taking medication.