Treating every patient with warmness of the soul, kindness and concern PATIENT FORMS New Patient Forms If you are a new patient to Ada West Dermatology, please select one of the pertinent registration forms below to print off and fill out. Form A (Adult): New Adult Patient Registration Forms Form B (Pediatric): New Pediatric Patient Registration Forms (including “Treatment Consent for Minors”) At your first scheduled appointment, please bring this form, your driver’s license, medical insurance card(s) and (if applicable) your referral authorization to expedite the new patient registration process upon your arrival. Office Policies HIPAA Privacy Policy HIPAA Authorization Form No Show Policy Medical Records Forms At Ada West Dermatology, we recognize that you sometimes need to transfer medical records to and from our clinic. Should you need to request outside medical records to send to Ada West Dermatology, please use Form 1. Should you need to release your medical records from Ada West Dermatology to another outside office, please use Form 2. Form 1: Request Records from Another Medical Office to Ada West Dermatology Form 2: Send Your Ada West Dermatology Records to Another Medical Office Telehealth Device Setup If you have an upcoming Doxy.me telehealth virtual appointment, your smartphone/tablet will need to be setup before the first visit. This is a one-time setup that will allow your device’s camera and microphone to connect to your clinician by live video in a virtual exam room on the Doxy.me website. Just click on the device-specific instruction set that applies to you–instructions on page 2 are also included on what website to link up to based on your scheduled provider: Android Phone/Tablet Patient Doxy.me Setup and Connection Instructions iPhone/iPad Patient Doxy.me Setup and Connection Instructions Once you have setup your device using the above instructions, please go to this website to test/verify your setup before your virtual appointment: https://doxy.me/precall-test/ Surgical Instructions Pre-operative Care Instructions For the patient that will be undergoing an outpatient procedure at our clinic. Surgical Information: Pre-operative Patient Instructions Mohs Surgery: Pre-operative Instructions Post-operative Care Instructions For the patient that has already undergone an outpatient procedure at our clinic. Surgical Information: Post-operative Patient Instructions Patient Forms Patient Portal Login Pay Bill Online 1618 S. Millennium Way, Suite 100, Meridian, ID 83642 4574 N. Ten Mile Rd, Suite 120, Meridian, ID 83646 (208) 884-3376 Website designed by Burst Designs