Welcome to Dermatology Associates of Northern Virginia Sterling, now a part of U.S. Dermatology Partners! 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 contains:
- New Patient Registration Form
- Minor New Patient Registration Form
- Medicare New Patient Registration Form
- Update Patient Information Form
- Minor Consent Form
- HIPPA Notice of Privacy Practices Form
- HIPPA Acknowledgement Form
- Patient Responsibility Agreement
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.
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.
Coolsculpting Patient Take Home Guidelines
Aftercare Instructions for Injectable
Acne Patient Information
Aldara Cream Information
Wart Treatment Information
UVB Phototherapy Information
Post Surgery/ Procedure Instructions
Post Surgical Procedure Instructions
Laser Hair Removal Post Care Instructions
Max G 1540 Post Care Instructions
PDL Post Care Instructions
Microdermabrasion Post Care Instructions
Light Peel Post Care Instructions
Melanage Peel Post Care Instructions
Melanage Minipeel Post Care Instructions
TCA Peel Post Care Instructions
Sculptra Post Care Instructions
Canthacur Post Care Instructions
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.