Battle Creek, MI 269-660-1670
Kalamazoo, MI 269-342-2991
Jackson, MI 517-787-5350
Sturgis, MI 269-651-1670
Angola, IN 260-665-1670
Hillsdale, MI 517-437-2490
Attention Patients: If you have an upcoming appointment, please call us if you have a fever, cough, or shortness of breath or have been in contact with someone under investigation for the COVID-19 (Coronavirus) infection. Please call to reschedule your appointment for when you are feeling better.
Get started today.
Schedule an appointment today to improve the health of your skin.
Battle Creek
Kalamazoo
Jackson
Sturgis
Angola, IN
Hillsdale
Convenient Patient Forms
To reduce time for your first visit, please print the appropriate forms. Fill them out and bring them along for your appointment. The team at Dermatology & Skin Surgery Center, looks forward to helping you.
Time-Saving Registration Forms
All new patients will need to complete the following
- Patient Registration Form
- Medical History Form
- Consent For Treatment and Financial Policy
- Notice of Privacy Practices
Simplifying matters for you
Take the time you need to get all your information correct before you come in; make sure you have your insurance information correct, and all of your contact information.
You will need to fill out each form in full before you can turn them into the front desk staff; we need copies of the Patient Registration form, Privacy Practices form, Insurance Payment form, and if it's applicable to you, the Medicare Form.