Patient Forms

Dermatology Associates of the South Bay Expedite Patient Registration Process

Forms and information to make your visit as quick and pleasant as possible.

Welcome to the office of Dr. Amber Kyle, Dermatology Associates of the South Bay. It is our sincerest goal to make your visit as pleasant as possible. If you are a new patient or we haven’t seen you for 3+ years, we have a few forms (seen below) to fill out to prepare you for your visit. Please bring them with you along with your current Insurance card and Photo ID.

Registration Form/Face Sheet

Patient History Form

Patient Consent Form & Privacy Policy Form

Terms & Conditions – Medical

Terms & Conditions – Cosmetic

Optional: Cosmetic Questionnaire Form

If the patient is a minor:

Please understand  if your child is a minor, it’s extremely important one parent accompanies the patient at each and every appointment. Important information is always discussed, and if we have to change medications it’s imperative a parent is present. If something comes up (last minute) and you can not attend the appointment but still want your child to come with a family member,  please call the office for instructions.

Need Medical Records from an old office or from this office?
Medical Records Form 

Please either mail in this form or bring it in to the office to receive your records. There may be a slight charge for the preparing and copying of your records.

Forgot your Biopsy Care sheet? Click HERE to read your instructions.

 

Please read: Privacy Policies/Practices