Dermatology Specialists of Kansas City, P.C.

Welcome to DermSpecialists.net

In order to make check-in with us as smooth and quick as possible, please complete the following patient information form and bring it with you to your appointment.

Patient Information Sheet
contains Patient Personal information, Insurance Release Form and HIPPA Consent Form

* You will need Adobe Acrobat Reader to view these files. If you do not have it, get it here.

Save Time And Complete Your
Patient Forms Before Coming In.

Instructions

1. Open the form.
2. Print the form.
3. Complete the form by hand.
4. Bring the completed forms to the office when you come for your appointment.

1. Open the form.
2.Complete the form on your computer (except for the signatures).
2. Print the Form.
3. Sign the form in the appropriate places.
4. Bring the completed forms to the office when you come for your appointment.

Save Time And Complete Your Patient Forms Before Coming In.

Instructions

Save Time And Complete Your
Patient Forms Before Coming In.