Patient Information

Patient Information

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.

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 the following insurance plans:

  • United Healthcare
  • Medicare
  • Cigna
  • Carefirst Blue Cross Blue Shield
  • Anthem Blue Cross Blue Shield (PPO plans only)

We are out-of-network providers for all other health insurance plans and 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. All sales are final. 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.

We use third-party labs for biopsies and blood work. If your insurance requires use of a specific lab in order for laboratory fees to be covered, you must notify us about this 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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