New Patient Forms

Visiting the office for the first time? Then please follow the two-step process below to make your first visit a breeze!

Step 1: Complete your New Patient Forms

Please 1) open and print the New Patient Forms, and then 2) complete them and bring them with you to your first appointment. These forms request basic information that the office needs to create your account. You will need Adobe Reader to view the forms. If you don’t have this program, download it here for free.

• New Patient Forms
• Notice of Privacy Practices

Step 2: Complete your Medical History Questionnaire

Please submit your Medical History Questionnaire online before your first appointment by going to your Patient Portal.
If you are visiting the Patient Portal for the first time, and do not already have a username and password, then you will need to Create an Account. To Create an Account, you will need:

• Your First Name
• Your Last Name
• Your Date of Birth
• Your home address Zip Code
• Your Patient Portal Security Code (given to you by the office when you made your appointment), and
• Our practice ID (VMAYEA).

All of this information will need to exactly match what the office has on file for you. Once logged in, go to myDocuments -> Forms -> Dermatology Online History -> Start Form.
If you have difficulty logging in, please contact the office!