Patient Resources, Forms, and Links
To Our Valued New Patient
Thank you for choosing Summit Dermatology. We look forward to helping you with your skin care needs and concerns. For your convenience, we use an automated telephone reminder system, which will notify you of the date and time of your appointment three days beforehand. However, we do require our new patients to arrive 20 minutes prior to their scheduled appointment time. This allows time for you to check in on our electronic kiosk and provide your medical information for our electronic medical record. If it becomes necessary for you to cancel your appointment, please notify us at least 24 hours in advance. Minors (under 18 years of age) are required to bring a parent or legal guardian to the first appointment.
Please bring your insurance card(s) and a method of payment for your co-pay. If you are not insured, you will be required to pay for your visit in full before you leave the office, unless other arrangements have been made with the billing office. If you need to verify your insurance availability, please contact our billing department or your insurance company for verification.
We look forward to getting to know you and thank you for your cooperation. If you have any questions, please feel free to call our office.
Sincerely,
The Staff at Summit Dermatology
Dear Valued Patient
Please arrive 20 minutes prior to your appointment time to check in on our electronic kiosk and update our medical record system with any changes in your medical history. If it becomes necessary for you to cancel your appointment, please notify us at least 24 hours in advance. Minors (under 18 years of age) are required to bring a parent or legal guardian to return visits unless consent has already been provided to our office stating the minor can be seen alone.
Please bring your insurance card(s) and a method of payment for your co-pay and any past-due balances. Keep in mind that new insurance cards are distributed at the beginning of the calendar year. Giving us the most current information and insurance card will help us file your claim correctly and avoid having to ask for additional information later.
The staff at Summit Dermatology always appreciates the understanding of our patients.
Sincerely,
The Staff at Summit Dermatology
Below are downloadable PDF forms for medical records release requests:
- Release of Medical Records to Summit Dermatology
- Release of Medical Records from Summit Dermatology
We have provided a series of handouts that are downloadable and printable for your information. Please click on a link below to download the appropriate form.
- Sun Protection Recommendations
- Treatments
- Instructions
- Accutane
- Wound Care
Click on a link below for more information on a specific condition:
Find Summit Dermatology’s list of recommended providers below for services that we do not offer. Please feel free to contact our office directly with any additional questions.
Laser Hair Removal Center, L.L.C.
LHRC utilizes the capabilities of Professional Electrolysis and State-of-the-art Lasers to ensure a successful outcome for their clients. The center is under the direction of John Uhler, Certified Electrologist and Medical Director Kevin Whaley M.D., Summit Dermatology, Board Certified Dermatologist. The center offers a complete treatment plan to provide clients with permanent results in Colorado Springs, CO.
At Summit Dermatology, we are committed to protecting your personal information and your privacy. This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment, or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI. Please review it carefully to understand how we manage your information and the steps we take to ensure its security.