Patient Forms

We look forward to taking great care of you.

Patient Forms and Resources

If you prefer not to use the electronic Patient Portal, you may download and complete selected forms by hand and return them to us via email, fax, or in person.

Patient Portal Guide
Preparing for Surgery (Preoperative Instructions)
After Surgery
Medical History Form
Financial and Privacy Policy Acknowledgement
Release of Medical Records
Privacy Practices
Non-Discrimination Policy

Information You Can Trust

Learn About Skin Cancer

Skin Cancer Support

See What Our Clients Are Saying

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Just a note to thank you for being so diligent in your pursuit of skin cancer. Because you caution 'on the safe side', you were able to detect my basal cell (carcinoma) very early. I also want to thank you for referring me to Dr.  Dhir. He was a dear! Thanks again for your care!

—ME
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Thanks for being so kind to me during my recent surgery. You are beautiful people.  With love and best wishes.

—BC
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A young lady at the entrance greeted me in such a friendly manner that the expression on her face, her posture, and her words caught my attention. The instructions are also striking: "you may bathe", "please try to stop smoking", "we would prefer", "please perform a few days", "please be patient as you heal." And finally, "We wish you a speedy recovery." These instructions come from doctors and nurses who are authorities in dermatology. Yet, they are delightfully modest.

—W
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Dr. Dhir and Jackie, I am blessed to have you be my Mohs team!  Thank you!

—DF
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How can I possibly explain how much you have meant to us. When you took the Hippocratic Oath, it must have had an addendum that covered care and compassion. You are truly special and I feel so blessed to know you.

—SS
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Just wanted to drop you a note to let you know that I'm very pleased with the outcome and appreciative of your superb skill as a surgeon.

—SP
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I just wanted to let you know how much I appreciate the care, concern, and compassion you showed me yesterday when I was in for surgery. Thanks so much for explaining everything to me and for being so thorough. You have a wonderful manner about you and you really set my mind at ease. Your willingness to allow me to call you at home put you over the top! I have great respect for you and will not hesitate referring others to you. Thank you again for sharing your gifts with me.

—MAE
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Thank you for the surgery on my right eye area + the kind + wonderful way you and your staff treated me.  I was upset for being late and you all made me so relaxed and welcome.  My sincere thanks.

—SM
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Thanks for your friendly service provided by your staff and the best and most efficient healthcare from the heart of one of the most prestigious physicians in Dermatology.

—KR
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Thank you for your kind and professional care!

—FS