New Patient Forms and Instructions

 

Patient forms can be filled out on the patient portal.  Below you will find PDF's of the forms needed for your appointment at Raleigh Skin Surgery Center.  Please fill out and print the Patient Registration and HIPAA Acknowledgement Form, Authorization for Release of Information Form, and Medical History Form.  Bring these completed forms with you to your appointment.  The Mohs Surgery General Instructions, Notice of Privacy Practices, and Medical Records Release Form do not need to be printed, but please read through these documents prior to your appointment.

The following forms are necessary for your appointment:

Please read through the following documents prior to your appointment:

Raleigh Skin Surgery Center's sole focus is Mohs Micrographic surgery, a form of skin cancer surgery for basal cell carcinoma, squamous cell carcinoma, and certain other forms of skin cancer.

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Phone: (919) 390-0200   Fax: (919) 390-0219   Email: info@raleighskinsurgery.com   Click here to get to the Patient Portal

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