Patient Info

Patient Forms

make your visit to us as convenient as possible.​​

 

New Patient Paperwork

 

Please print and fill out these forms and bring them to your appointment. Please arrive 15 minutes prior to your appointment for us to process your paperwork. If you are unable to fill out your paperwork prior to your arrival, please arrive 30 minutes before your appointment to fill out paperwork in the office and to allow time for us to process your paperwork. Thank you for choosing Atlanta Dermatology & Laser Surgery for your dermatology needs. We look forward to seeing you at your appointment!

 

Patient Personal Information

Notice of Privacy Practices

Patient Medical History

Acknowledgement of Financial Policy

Authorization for Release of Protected Health Information

Patient Portal

Access your Atlanta Dermatology & Laser Surgery account here.

We strongly encourage you to register on our Patient Portal and, to protect the privacy of your personal health information, use the portal as your primary method of communication with our office! Sign up and access your Atlanta Dermatology and Laser Surgery account here.

Click Here

Important Information About Your Appointment

Atlanta Dermatology & Laser Surgery's policies and procedures for your review.

At Atlanta Dermatology & Laser Surgery, we are dedicated to providing you with the highest level of patient care.

Office Hours

We are open by appointment only Monday-Friday 8 a.m. - 5 p.m. and closed on Saturday and Sunday.
Cancellation & "No Show" Policy

If you cancel or reschedule an appointment on the same day, or do not show up for your scheduled appointment, there is a $25 fee. All outstanding balances must be paid in full before any additional services will be rendered.

Prescription Refills

Prescription refills are handled during regular office hours when we have full access to your medical records.

Medical Record Requests

Medical record requests are handled during regular office hours when we have full access to your medical records. Please allow 5-7 business days for the release of medical records.

Fees, Payment & Insurance

At Atlanta Dermatology & Laser Surgery we are proud to offer many ways to help you pay for your visits. We participate in nearly all major insurance plans, including (but not limited to):

Aetna

  • Blue Cross Blue Shield
  • Care Improvement Plus
  • Cigna
  • Coventry
  • Great West
  • Humana
  • Medicare
  • Meritain
  • Tricare
  • United Healthcare
  • Payment options include Cash or Credit Card (Visa, MasterCard, American Express, Discover). For cosmetic patients, we also offer CareCredit to meet your individual needs of cosmetic surgery, cosmetic dermatology, or injectables.

    CareCredit, a GE Money Company, gives you convenient payment options so you can get the procedure you want, when you want it. CareCredit makes it easy to apply with a simple one page application and immediate approval online. There are no up-front costs, no prepayment penalties and no annual fees. Once you have CareCredit, you can use it again and again without reapplying. You may apply online for a CareCredit payment plan, however please speak with our financial coordinator about which payment plans we offer by calling: 404-921-5509.

Hours

Monday8:00AM - 5:00PM
Tuesday8:00AM - 5:00PM
Wednesday8:00AM - 5:00PM
Thursday8:00AM - 5:00PM
Friday8:00AM - 5:00PM
SaturdayCLOSED
SundayCLOSED

Atlanta Dermatology And Laser Surgery

1462 Montreal Road W,

Suite 411,

Atlanta, GA 30084

Phone. 404-296-8000

Email. info@atlderm.com