Patient Forms & Info

New Patient Registration | Fill Out Online

Permission for a Minor to be Seen Without a Parent | Fill Out Online

Photo Consent Form | Fill Out Online

HIPAA Form – McLean Derm Releasing Info | Fill Out Online

HIPAA Form – McLean Derm Obtaining Medical Records from another Facility | Fill Out Online

New Spa Client Form | Fill Out Online

Insurances & Billing

We are in-network providers for Carefirst Blue Cross Blue Shield, Cigna, Medicare, United Healthcare, Virginia Health Network, and PPO plans through Anthem Blue Cross Blue Shield.

We are out-of-network providers for all other health insurance plans and we do not accept them. We do not submit claims for insurances that we do not accept (out-of-network insurances).

Payment for all visits which are not submitted to insurance is due in full at the time of service. We accept Visa, MasterCard, Discover, and American Express credit cards. We do not accept checks.

If your insurance requires referrals or pre-authorizations in order for your services to be covered, you must obtain these prior to your visit.

If you have questions about your bill please contact our billing department at 1-800-300-7819.

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