New Patient Forms

At PBC Dermatology, we work hard to assure you have the most thorough treatment, with consideration of your busy schedule. To help expedite the check-in process and minimize your wait time, please print and complete all your paperwork prior to your first appointment. If you have any questions about filling out the paperwork or problems downloading the forms and would like them mailed or faxed to you instead, please call us at 561.357.5636.

Appointment forms:

Patient Registration Form

Communication Consent Form

Financial Agreement Form

Patient History and Intake Form

Additional forms:

Health Care Insurance Terminology

Planning for Your Appointment

Commonly Used Procedure Codes

Understanding the Billing Process

Good Faith Estimate Notice