530-272-2303info@sierraderm.com SIERRADERM, Center for Dermatology • Northern California

Welcome new patients

We look forward to serving you.

New Patients

Welcome! We want your visit to our office to be a pleasant experience. Above you’ll find links to information regarding your visit. Please fill out all forms as completely and accurately as possible. This will allow us to have the necessary information to provide you with the highest level of care.

1. PLEASE PRINT ALL PAGES UNDER “DOWNLOAD PATIENT FORMS”

2. The HIPAA Privacy Notice is for your reference and does NOT need to be printed.

We ask that you complete this information prior to your visit and bring everything with you to your appointment. If you are not able to do this, please plan to arrive at least 15 minutes prior to your appointment time.

If you find that you need to cancel or reschedule an appointment we ask that you contact our office at least 48 hours in advance to avoid a missed appointment fee. This allows those who are waiting for an appointment the opportunity to be scheduled in your place.

  • Please sign all pages that require a signature
  • The HIPPA Privacy Notice is for your reference only
  • If you need to cancel or reschedule, please provide 48 hours notice
  • We are here to help, have questions? Call us.
  • Financing and payment plans are available
  • Minors NEED to be accompanied by an adult

Financing/Payment Plans

As a service to our patients, we are pleased to offer direct financing for cosmetic procedures through CareCredit, the nation’s leading healthcare financing program. CareCredit has a simple application process and immediate approval online – this can usually be completed while you are still in the office. A full range of extended payment plans are available with CareCredit.

The application process is only done once and may be used again without reapplying. If you are interested in discussing this credit payment plan option, please ask a member of the staff and they will be happy to provide you with the information and the short application form.

Insurance.

We accept a wide range of medical insurance programs. Please contact us for more info.

Minors

Please note that all patients who are under the age of 18 must be accompanied by a parent or legal guardian to receive treatment.
If a follow-up visit is necessary, a form may be signed by the minor’s parent or legal guardian that gives us permission to treat an unaccompanied minor.

Please contact our office if you should have any questions prior to your appointment. We look forward to seeing you at your visit!