New patients: Read the
welcome letter and fill out the
acknowledgement and consent, and
patient registration forms prior to your upcoming dermatology appointment.
Referrals: If your insurance carrier requires a referral to see a dermatologist,
please contact your primary care provider to initiate a referral
prior to your appointment.
Transfer of Medical Care: If you would like to transfer your care from a previous physician to Advanced Dermatology of Oregon, please fill out the
medical information release form and fax it to your previous physician.
For Referring Physicians: If you would like to refer a patient to Advanced Dermatology of Oregon, please fill out the
physician referral form and fax it to 503-692-8643.
1. Welcome Letter
2. Medical History
3. Financial Policy
4. Medical Release of Information
5. Patient Registration Form
7. Cosmetic Interest Questionnaire
8. Acknowledgement and Consent
9. Notice of Provider Privacy Practices
10. Telemedicine Verbal Consent