Patient Forms

For new and existing patients

Consent forms for new patients to accept outpatient services from our office. 

This must be reviewed by all new patients before their first visit. Patients can sign this on our iPad when they check-in for their appointment.

Policies outlining financial responsibilities of patients for receiving services from our office and rules regarding missed appointments and cancellations.

This must be reviewed by all new patients before their first visit. Patients can sign this on our iPad when they check-in for their appointment.

Consent form required to be signed by parent or legal guardians of minors (under the age of 18) in order for us to provide health care services. 

This must be completed only for minors before their first visit, in addition to new patient consent and financial / office policies forms. Parents or legal guardians can sign this on our iPad when they check-in for their appointment

This form is required to be completed and signed only by patients who request their medical record information to be transferred to or from Bluebonnet Dermatology.

Patients can sign this paper form provided by our front desk if this form is applicable to them.

 

Phone: (469) 663-8838

Fax: (469) 472-0861

935 W Exchange Pkwy, Building B, Suite 130, Allen, TX 75013

Office Hours:
Monday 9:00am - 4:15pm

Tuesday 9:00am - 4:15 pm

Thursday 9:00am - 4:15pm
Friday 9:00am - 4:15pm

©2020 by Bluebonnet Dermatology