Thank you for choosing Lake Dermatology. We realize that you have a choice of where to be treated. We also realize that you place a great deal of trust in your physician to provide you with the most up to date information and treatment options regarding your skin care health. We do appreciate and value the trust you have placed in us.

We have included our Patient Registration forms below. Please complete each form and bring them with you to your appointment.

We have included a records release for your convenience. The following list is an example of people who may need to complete this form and send it to the office that holds your records:

• Previous patients of Dr Lake’s
• Patients referred by another doctor
• Patients that have seen another dermatologist

If you have any questions or concerns, please do not hesitate to ask any member of our team.

       Warmest Regards,
       Lake Dermatology


Additional things to bring to your appointment:

• Insurance cards
• List of all medications, over-the-counter medications, and herbal supplements

      

Records Release Sheet

Release of PHI

If you cannot view the forms, you may need a PDF reader.