Patient Forms

Intake Forms

Save time before your first appointment! Please complete the following simple intake forms and bring them with you. We will also need a copy of your photo ID, and copies of medical insurance cards, if applicable, so please bring these with you.

If any of your information changes after your initial form is on file, please fill out a new form and update any relevant information. In order to make life a bit simpler, we have forms that you can actually fill out online.

Instructions:

Simply fill out your form, print, and send to us via e-mail or bring them with you when you next visit.

Any completed forms may be sent to nurses@lakesdermatology.com

Downloads:

• 2024 Patient Info Sheet – All Patients
• Medical Insurance Form
• 2024 Health Questionnaire – All Patients

Medical Records

If you need copies of your medical records, please fill out this request form and mail or fax to us. We will let you know if a fee applies before we send any records.

Downloads:

• Medical Records Form

Please read our 2024 No Show and Cancellation Policy.