Patient Info

Welcome to Brilliant Dermatology and Aesthetics!  Below are new patient forms.  To facilitate your visit, please fill them out and bring them with you on the day of your appointment. If you prefer not to pre-fill them, please arrive 15 minutes early

When you come for your appointments, please remember to bring the following

• Driver’s License or a valid ID
• Insurance cards
• Referral Letter (if required)
• Biopsy reports, laboratory results,  or any other relevant information you would like us to review
• List of medications with dosages
• Form of payment
• Dependents under the age of 18 should be accompanied by a legal guardian

To cancel an Appointment

Please telephone the office during business hours and allow at least 1 days’ notice so that we can offer your appointment time to patients on our waiting list.

Patient Portal

We utilize Modernizing Medicine’s Electronic Health Record.  At your first visit, you will be given login information to access the portal.

Insurance

We currently accept Medicare, Aetna, Blue Cross Blue Shield, United Healthcare, Tricare, and many other commercial carriers. Please call us today for the most updated list of insurances.

Private Pay

Brilliant Dermatology & Aesthetics offers a low self-pay rate for those who are uninsured. Please contact us for further inquiry.

Registration Form

You will need the Adobe Reader to view and print the above document.