Our experienced, competent and caring Provider Team will provide you with excellent dermatology care

Battle Creek, MI 269-660-1670

Dermatology & Skin Surgery Center, PLC - Dermatologist Battle Creek

Kalamazoo, MI 269-342-2991

Jackson, MI 517-787-5350

Sturgis, MI 269-651-1670

Angola, IN 260-665-1670

Hillsdale, MI 517-437-2490

Convenient Patient Forms

To reduce time for your first visit, please print the appropriate forms. Fill them out and bring them along for your appointment. The team at Dermatology & Skin Surgery Center, looks forward to helping you.

All new patients will need to complete the following

• Patient Registration Form

• Medical History Form

• Consent For Treatment and Financial Policy

• Notice of Privacy Practices

Time-Saving Registration Forms

Take the time you need to get all your information correct before you come in; make sure you have your insurance information correct, and all of your contact information.

You will need to fill out each form in full before you can turn them into the front desk staff; we need copies of the Patient Registration form, Privacy Practices form, Insurance Payment form, and if it's applicable to you, the Medicare Form.