New Patient Registration
To start the registration process:
- Click on this link to start the process: Register Now
- Please fill out all of the paperwork. THIS MUST BE COMPLETED PRIOR TO ARRIVAL at the office.
- Your username is your first and last name all lowercase with no spaces in between
- Your password is the first initial of your first name (capital) and the first initial of your last name
- (lowercase) and your birthdate (month day year)
- John Smith 09/22/1969
- Username: johnsmith
- Password: Js09221969
- It will then prompt you to reset your password to a new private password.
- Past Medical History
- Skin Disease History
- Social History
- Family History