Patient Info

New Patient Forms

Please complete and print these New Patient Forms and bring them to your appointment

Patient History and Intake Form

Acknowledgment of Privacy Practices

Acknowledgement of Financial Policy

We ask that you arrive 15 minutes before your scheduled appointment so we can process your New Patient Forms and you can see your provider on time.   
If you are not able to bring the completed forms with you, please arrive 30 minutes early so you can complete your paperwork in the office and we can process it before your scheduled appointment.

Thank you for choosing Atlanta Dermatology & Laser Surgery for your dermatology needs. We look forward to seeing you!

Patient Portal

Access your Atlanta Dermatology & Laser Surgery account here.

Please Register for Our Patient Portal!

To satisfy the Promoting Interoperability standards established by the Federal Government, and to provide the best possible care to you, we have established a Patient Portal that you can use to

 Review and verify your contact information;

 Input and update your medical history, including medication, allergy, social/ family history, referring physician and preferred pharmacy information;

 View finalized notes and handouts from your visit;

 Check on your test results; and

 Communicate with our clinical staff.


STEP ONE: When you arrive at the office, share your e-mail address with our front desk attendant, and ask her to activate you in the Patient Portal.

If you do not have email, or you would like to create a username different from the email address, let the attendant know so she can activate you manually and set up your user name and password, and you can skip to Step Three.

STEP TWO: Look for a “Welcome” email with a link to access the registration site. You will be prompted to provide the information needed to set up a Username and Password.


• Open your Internet browser and enter in the address bar.

• Input your User Name and Password.

• You’re in!

If you have any questions, please contact the office at 404-296-8000

If you are already registered and would like to access the Patient Portal, 

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-Thursday 8 a.m. - 5 p.m and Friday 8am - 12:30 p.m.  We also schedule cosmetic appointments on the second and fourth Saturdays of each month from 9 a.m. - 1 p.m.

Cancellation and 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. In order to release medical records we will need you to sign this authorization form:

Click Here  

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):  

  • Blue Cross Blue Shield
  • Care Improvement Plus
  • Cigna
  • Coventry
  • Great West
  • Humana
  • Medicare
  • Meritain
  • Tricare
  • United Healthcare

  • We also accept self-pay patients, of course.   For self-pay, co-pays or charges under your insurance deductible, and for cosmetic dermatology products and services, 
    we encourage payment by debit or credit card (Visa, MasterCard, American Express, Discover).   We also offer CareCredit for cosmetic laser treatments and injectables.  

    CareCredit, a Synchrony Financial 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 here for a CareCredit payment plan, however please speak with our financial coordinator about which payment plans we offer by calling: 404-296-8000. 


    Please fill out the form below and we will contact you as soon as possible.  

    If you need immediate assistance please call:

    ATL DERM - 404-296-8000

    ATL SKIN 470-275-9417 


    Monday8:00AM - 5:00PM
    Tuesday8:00AM - 5:00PM
    Wednesday8:00AM - 5:00PM
    Thursday8:00AM - 5:00PM
    Friday8:00AM - 4:00PM
    Saturday8:30AM - 12:30PM