Forms page


Please find below PDF files for helpful reference.  Both the Health History Form and the HIPAA consent need to be printed, completed and brought with you on the day of surgery.

Health History
and Medical intake Forms

Please print out the above form and complete all of the health history questions.  You should bring this form, as well as the HIPAA consent with you on the day of your surgery.

Instructions for your Mohs surgery

Please feel free to browse the above document. It contains frequently asked questions (and answers) about Mohs surgery and what to expect before and after surgery.

This document reviews the Mohs procedure and explains how your day will go when you come to the office to have your skin cancer removed.

If you have any questions regarding office policies, feel free to peruse our office policy document.

Consent for Mohs surgery

Please take a few minutes to look over the general surgical consent form. On the day of your surgery, you will be asked to sign this form.

List of insurances & payment policies

Above is a complete list of the insurance plans with which we participate as well as 

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Call 419-479-5795

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