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.







  • Please arrive at least 15 minutes BEFORE your scheduled appointment time. This is to allow enough time to complete the registration and rooming process.
  • Our providers make every effort to stay on schedule because we VALUE your time.





  • 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.
  • If you are not able to keep your appointment, please call us at 402-413-7460 at least 24 business hours before your appointment time.  A short notice cancellation does not allow us enough time to offer the appointment time to another patient.
  • Patients who “No Show” will be billed $50.00 for the missed appointment time.  The fee must be paid in full before another appointment can be scheduled.
  • Patients who arrive more than 10 minutes PAST their appointment time will be considered a “No Show” and asked to reschedule.
  • Appointments cancelled or rescheduled without a 24 business hour notice will be considered a “No Show” and billed a $50.00 “No Show” fee.
  • New patients who miss their first appointment will not be rescheduled until their Primary Care Provider conducts a peer-to-peer phone call with one of our Providers.




  • If your check is returned for insufficient funds, you will be charged $30.00 per 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


Dermatology Associates of Lincoln
6969 South Street
Lincoln, NE 68506
View Map


Phone: 402-413-7460
Fax: 402-413-7486


Clinic Hours
M/W/TH/F: 8am–4:30pm
Tuesday: 7am–4:30pm

Phone Hours
M/W/TH/F: 8am–5pm
Tuesday: 7am–5pm