PATIENT FORMS

NEW PATIENT FORMS

If you are new to the practice, or have not been seen in 3 years, please print and complete the following, and bring them to your visit.

If you are being seen for a hair loss consultation, print and read the following:

RETURN PATIENT FORMS

If the calendar year has changed, or six months have passed since your last visit, please print and complete the following, and bring to your next visit.

If you are being seen for a hair loss consultation, print and read the following:

PAYMENT OPTIONS

Insurance Plans

Our practice participates in the following insurance plans:

  • Blue Cross Blue Shield
  • Blue Care Network
  • Health Alliance Plan - Providence Group
  • Medicare
  • PPOM
  • Smartplan
  • Aetna

If you do not see your insurance plan listed here, please call us or your insurance company for more information on our participation status.

S.K.I.N. SPA PATIENTS

Print the following and bring to your next visit.

If you can't open the forms, you'll need to install the Adobe Reader. Click the button below to install:

Other Payment Options

We gladly accept the following payment types:

  • New patients: Visa, MasterCard, Care Credit, cash
  • Returning patients: Visa, MasterCard, Care Credit, personal check, cash

SKIN DISEASE INFORMATION

Michigan SKIN Associates provides medical and surgical Dermatology services.  Reema Sutariya is our primary general practitioner, working closely with Dr. Edwards.  Commonly treated skin conditions include:

Connect with Michigan
Skin Associates

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