Patient Forms

At Stockton Dermatology, we have a secured Certified Electronic Medical Records for our dermatology patients.  You are able to register online.  Call our office to receive your secured access code to register or update your Medical History.

If you prefer, you may download the New Patient Registration Forms to fill out and bring with you to your dermatologist appointment.

Additionally, we ask that you arrive 15 minutes prior to your dermatology appointment so that we can confirm all of your information correctly in our computer system.

Thank you for your patience!

In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.

IMPORTANT INFORMATIION REGARDING GOVERNMENT FUNDED PROGRAMS

We are not contracted with any AHCCCS plan. It is recommended that you stay within your network for any medical treatment. They do NOT permit you to be a cash pay patient with a non-contracted provider.

If you need help selecting a provider in your Network, please visit: www.azahcccs.gov/choice or by calling (602) 417-7100. Should you attempt to submit a claim, Note it will automatically by denied per the Arizona AHCCCS Government Program.

What To Expect

Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment with a dermatologist. We invite you to take some time to review our staff page and familiarize yourself with the dermatologists. We look forward to your first visit.

Payments

We accept Visa, Mastercard, Discover and American Express. Call our dermatology office for more information.

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