PATIENT REGISTRATION FORMS
Prior to your arrival, please try to complete the following forms and bring them with you:
> NEW PATIENT REGISTRATION FORMS (3 PAGES)
Esthetics Center for Dermatology will be able to provide appointment availability within a few days, if not the same day. Please call 704.370.2700 and select option 1 during our regular business hours to schedule an appointment. The receptionist may ask about the nature of your illness or the reason for your visit to assist in scheduling the physician’s time more efficiently.
If further assistance or services are requested during the visit that were not described during the making of the original appointment, we may ask you to schedule another appointment date to address these issues or provide more services. By doing this, we can continue to provide respect for other patients and not compromise their appointment times and care.
We will make every effort to provide prompt service, but there may be cases of emergency or unforeseen delays. We will keep you informed as we acknowledge the importance of your time.
NEW PATIENT APPOINTMENTS
As new patient appointments require an extensive amount of time, we require these appointments to be secured with a valid credit card. Another form of approved payment can be made at the time of service if you choose to not use the credit card on file. If appointments are missed or cancelled with less than a 24-hours notice, we reserve the right to charge an initial cancellation/no show fee of $35 on the credit card on file. Repeated missed appointments will be charged $60.
No shows and late cancellations cause problems that go beyond a financial impact on our practice, as it takes an available time slot away from another patient needing care. Please refer to our “Cancellation, No Show, and Late Policy” for more details.
Please provide sufficient time for travel to ensure your prompt arrival. To save time, registration forms can also be downloaded from our website, printed, and completed prior to your visit. For security and verification purposes, we ask you to bring a valid/active photo identification card at your first visit, such as a driver’s license, state ID card, military ID, or passport.
Please remember to bring all of your prescriptions, over-the-counter medicines, vitamins, supplements and skin or hair products to the initial office visit. This will enable the physician to review the items and provide the appropriate care for you. Any copies of previous lab work or pathology reports related to your condition may be helpful to review during your visit. If complete medical records are needed, we will advise you of the need at the time of your visit.
For safety reasons and due to limited space, we ask parents to not bring children or other family members, unless they are scheduled to be seen as patients. We are limited to only two to three people in a treatment or exam room. Therefore, we request only those who are primary caregivers of a minor to accompany the child during the visit. All patients under the age of 18 must be accompanied by a parent, a guardian or an adult designated by the parent with written permission.
ELECTRONIC DEVICES RESTRICTED
Esthetics Center for Dermatology pairs the restful, soothing ambiance of a spa with the high-caliber care of a leading-edge medical setting. To ensure this atmosphere, please refrain from the use of cellular phones, pagers, or PDAs in the building. This is due to safety as well as courtesy. Please be sure to turn off your cell phone, pager or PDA ringer or put it on a silent/vibrate setting. If the call is urgent, please conduct the conversation outside the building. We sincerely thank you for your cooperation.
Dr. Fuller’s practice philosophy is to foster active collaboration with her patients and acknowledge the crucial role you play in cultivating your own healthy looks and lifestyle. Let’s work together to give you the happy, healthy skin, hair and nails you deserve.