Welcome to our Patient Resources Center. Here you can access patient forms online, learn about the insurances we accept and find out more about financing which we offer through CareCredit®. We appreciate the trust you have placed in us and want you to know we are committed to doing everything we can to make your experience as comfortable and pleasant as possible. Thank you for choosing Contour Dermatology & Cosmetic Surgery Center.
Use the links below to find the patient resources that best fit your needs.
We are pleased to offer you the convenience of secure online patient registration. Now you can fill out the required Medical History form online in the convenience of your own home. This will also save you time during your office visit! Click here to login
Once you have made your appointment, our office will provide you with the security code you will need to access the patient login section of our website so you can enter your Medical History.
If you scheduled your appointment online or you didn’t get that information when you called for your appointment, please call us or e-mail us to obtain the security code. After entering the code, you will be prompted to create your own secure account by selecting a username and unique password which should be at least eight characters including letters and numbers. Once you click submit after creating your account, you can then enter your Medical History information.
Please know that our online patient portal features the highest security features possible so you can be assured that your information is absolutely secure in the way the data is submitted and can only be accessed by our staff.
Once you are in the system, you can update your account at any time to reflect any medical information such as new prescriptions.
Please call our office if you have any questions about getting set up with the patient login.
Download Other Patient Forms
Besides the required Medical History form which is available through the patient login section of this website, there are other important forms which you may need to fill out for your appointment. Click here to view and download forms and print the ones that apply to you and fill them out prior to your appointment. If you have any questions about which forms you should complete, please contact our office for assistance.
All forms are in PDF format.
- Patient Registration Form
- Financial Agreement For Cosmetic Procedures Form
- Notice of Privacy Practices
- Notice of Privacy Practices – Patient Acknowledgment
- Advanced Beneficiary Notice – General
- Medical Records Request to Obtain
- Medical Records Request for Release
- Authorization to Discuss Medical Information
- Authorization and Consent for a Minor
- Patient Satisfaction Survey
- Credit Card on File Authorization Form
- Blue-U Blue Light Photodynamic Therapy
- Botox Dysport
- Chemical Peel
- Fat Transfer
- FSD MicroTherapy
- Hair Loss for Women
- Hair Transplant
- IPL FotoFacial
- Laser Hair Removal
- Massage Therapy
- Mini Facelift
- MOHS Micrographic Surgery
- Scar Treatment
- Smooth Beam
- Sublime (Refirme) Laser
- Tattoo Removal
- Vela Shape II
- XTRAC Laser
Contour Dermatology and Cosmetic Surgery Center accepts the following insurance plans. If you don’t see your plan listed, please call our office for more information. If we are not already a participant, we may like to become one. As a courtesy to our patients, we will submit to most PPO insurance companies for reimbursement even if we are not on their list of preferred providers.
- Aetna Health Plans
- Anthem Blue Cross Health Plans
- Blue Cross /Blue Shield Health Plans
- Blue Shield Health Plans
- Cigna Health Plans
- Health Net
- United Healthcare
Contour Dermatology & Cosmetic Surgery Center accepts CareCredit®, a personal line of credit for healthcare treatments and procedures that gives you convenient payment options so you can get the procedure you want, when you want it. CareCredit works like a credit card but it has two advantages. It can only be used for healthcare services, and you can get no-interest financing every time you use it. Simply pay your minimum monthly payment and pay off the entire balance by the end of your promotional period, and you pay no interest. If you need more time to pay for your procedure, you can take advantage of an extended payment plan with low, fixed interest rates.
Easy to apply, even easier to use
CareCredit makes it easy to apply with a simple one page application and immediate approval online. There are no up-front costs, no prepayment penalties and no annual fees. Once you have CareCredit, you can use it again and again without reapplying.
Your trusted financial partner
CareCredit is a Synchrony Bank Company and the nation’s leading patient-financing program, earning endorsements from a long list of credible healthcare organizations. For the past 20 years, they’ve helped more than 6 million cardholders get the treatments they want and need. Click here to proceed to the application.