Forms & Policies
Patient Forms
If you do not have access to your patient portal, you can download and print the registration forms and complete them before your appointment.
Patient Registration Forms
Patients with Medicare (only):
Medical Records Release
PRACTICE POLICIES
ARRIVE ON TIME
- Please arrive at least 15 minutes BEFORE your scheduled appointment time. This is to allow enough time to complete the registration and rooming processes.
- Our Providers make every effort to stay on schedule because we VALUE your time.
LATE ARRIVALS
- If you are running late, please call us as soon as possible. We will then determine if we can make an adjustment to the schedule to see you. It is important to understand that a late arrival may result in an increased wait time for you. Or we may need to reschedule your appointment.
- If you arrive more than 10 minutes PAST your appointment time without contacting the office, you will be considered a “No Show.” You will be charged a $50.00 “No Show” fee and asked to reschedule.
RESCHEDULES/CANCELLATIONS
- If you need to cancel or reschedule your appointment, please call us at least 24 business hours before your appointment time. When you cancel or reschedule your appointment on the same day, you prevent another patient from getting much needed treatment.
- If you cancel or reschedule your appointment on the day of the appointment, you will be charged a $25.00 “Cancellation” fee. The fee must be paid before you schedule your next appointment.
MISSED APPOINTMENTS
- If you “No Show” your appointment, you will be charged a $50.00 “No Show” fee. The fee must be paid before you schedule your next appointment.
- If you are a new patient and “No Show” your first appointment, you will not be able to reschedule your appointment until your Primary Care Provider conducts a peer-to-peer phone call with one of our Providers.
RETURNED CHECK POLICY
- If your check is returned for insufficient funds, you will be charged a $30.00 “Returned Check” fee for each returned check.
Medical Records
If you need access to records that are not available on your patient portal, please
print and complete the medical records request form and fax or mail it to:
Dermatology Associates of Lincoln
6969 South Street
Lincoln, NE 68506
Fax: 402-413-7486
LOCATION
Dermatology Associates of Lincoln
6969 South Street
Lincoln, NE 68506
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Contact
Phone: 402-413-7460
Fax: 402-413-7486
Hours
Clinic Hours
M/W/TH/F: 8am–4:30pm
Tuesday: 7am–4:30pm
Phone Hours
M/W/TH/F: 8am–5pm
Tuesday: 7am–5pm