Patient Forms

Allegheny Advanced Dermatology Center Patient Forms

Patient Registration and Privacy Practices

For your convenience, you may view and print our Patient Registration form, Notice of Privacy Practices Acknowledgement, and Notice of Privacy Practices below. If you prefer, you may complete the applicable forms and bring them with you to your appointment. Paper copies are available at the office, as well. If you prefer to complete your forms at our office, please plan to arrive approximately 15 minutes prior to your scheduled appointment time.

New Patient? Change of Information? Save Time

The following PDF forms have been provided to help new patients save time during their first appointment. If your information has changed, please update your patient registration form, as well. It is important that we have accurate information in your file. If you would like, please complete the forms below prior to your visit. Simply print out the Patient Registration form, fill in the information requested, and bring the completed form with you to your appointment. All new patients should also complete the Notice of Privacy Practices Acknowledgement.

Contact Allegheny Advanced Dermatology Center for answers to any questions you may have. Call: (814) 944-7109.