Formally Known As Leominster Dermatology

About Us

NEW PATIENTS

Patient Forms and Resources

Patient Resources

Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. Please download, print, and complete the forms and bring them with you to your appointment. If you are unable to download our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.

Printable and Online Forms

If you’re a new patient and registering for the first time, please fill out the New Patient Registration online version only.

Online Forms

1. New Patient Registration:

Online Form

2. Health Screening:

Online Form

3. Privacy Notice:

Online Form

4. Authorization to Use and Disclose:

Online Form

Printable Forms

1. Patient Registration:

Printable Form

2. Health Screening:

Printable Form

3. Privacy Notice:

Printable Form

4. Authorization to Use and Disclose:

Printable Form