New & Returning Patients

Patient Forms

Save time at your appointment by completing your forms in advance. You can fill them out digitally through our patient portal or print and bring them with you.

Prefer digital? Many of these forms are available through your patient portal. Ask our front desk team for your portal link if you haven't registered yet.

Required for All New Patients

Consent to Treat Minor

Required

Required for patients under 18. Must be completed and signed by a parent or legal guardian before treatment.

Demographic Form

Required

Basic patient information including name, address, date of birth, and emergency contact.

General Consent to Treat

Required

Standard consent for evaluation and treatment. Required for all new patients.

Medical History Form

Required

Comprehensive health history including current medications, allergies, prior surgeries, and family history of skin cancer.

Medication List

Required

A complete list of all current medications, supplements, and dosages.

Patient Information Record

Required

Insurance information, primary care provider details, and preferred pharmacy.

Situational / Specialty Forms

Cosmetic Consult Form

For patients scheduling cosmetic consultations (Neuromodulators, fillers, chemical peels, or laser treatments).

Cosmetic Financial Consent

Financial consent and payment agreement for elective cosmetic procedures.

MIPS Questionnaire

Quality measures questionnaire required by Medicare for eligible patients.

Questions About Your Forms?

Our front desk team is happy to walk you through which forms you need before your appointment.

Call (941) 444-0011

Ready to Book?

Schedule your appointment and get a same-week slot with a OnSpot dermatology professional.

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