PATIENT RESOURCES

Patient Demographic Information Form
Medical History Form
Medical Records Release Form

• www.dermnetnz.org
• www.aad.org/public/diseases

Please note, there is a $35 no show and cancellation fee if your appointment is not cancelled within 24 hours of your appointment.

For billing questions, please contact our contracted billing company MEDCOMM at 1-614-553-0997. Please have your patient account number handy or include it in your email so we can assist you better.

Co-payments and deductibles are due at the time of your visit. Per federal law, you must have your insurance card and photo ID at each visit. If you have questions, please call (614) 898-7546 to speak with a billing associate or manager prior to your appointment.

You are responsible for all costs not covered by insurance. For out-of-pocket expenses, including deductibles, co-insurance and co-payments, we accept Visa, MasterCard and Discover credit cards, as well as personal checks and cash.