New Patient Registration and Health Information Forms

Please download and print these two pdfs: New Patient History Form, and Patient Registration Form. Fill out your information, and bring these with you when you come into our office. Thank you!

Authorization for Use/Release of Health Information Form

Please download and print this pdf: Authorization for Use/Release of Health Information. Fill out the information and bring it with you when you come into our office. Thank you!

Patient Post-Experience Survey

Please download and print this pdf: Patient Post-Experience Survey. Fill out the information, and fax to us at 404-843-3469 or or you may complete it and e-mail it directly to us online at sharondaa@dermatlanta.com.

If you prefer to fill out the survey online instead, please click here. Thank you!