PATIENT FORMS
At Base Dermatology, we strive to make your visit as smooth and efficient as possible. To help streamline your appointment, we encourage all new patients to complete the necessary forms in advance.
New Patient Form
To ensure we have all the essential information for your care, please complete our New Patient Form before your appointment. This form includes:
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Personal and contact details
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Medical history and current medications
Credit Card Policy
Base Dermatology requires a credit card on file for all patients. This policy helps us simplify billing, handle copays, and process any outstanding balances efficiently. We prioritize the security of your payment information and adhere to strict privacy standards.
You may submit your completed forms by:
Emailing them to 248-355-5047
Faxing them to 248-355-3511
Bringing them to your appointment
If you have any questions, please call our office at 248-355-5047.
We look forward to seeing you!
Ready to Take the Next Step for Your Skin Health?
At Base Dermatology, we provide expert care tailored to your unique needs. Whether you’re seeking treatment for a skin condition, considering Mohs surgery, or simply looking to improve your skin’s health, our team is here to help.
Let us guide you toward healthier, more confident skin. Your journey starts here! One of our friendly team members will promptly reach out to confirm your appointment and answer any questions you may have.
