Before Your Visit

Patient Registration Forms

Please print, fill out, and bring the following forms with you when you come for your appointment:
We accept most major managed care PPO insurance plans and traditional Medicare. Please call the office for specific information regarding your insurance plan.

If we will be filing insurance for you, you will need to provide that information to us in advance. Please fax a copy of your insurance card (front and back) and the date of birth of the primary card holder of the insurance to 972-278-8691 or call to give your information to the receptionist. If not done in advance, your wait time in the office will be significantly longer.

Specialized products available for purchase in the office:

  • Active C (vitamin C)
  • Glyderm (glycolic acid products)
  • Teamine (Eye complex cream)
  • Elta MD Skin Care Products (Sun Screen)
  • MD Forte Facial Cream (contains glycolic acid)