New patients and those not seen within a year, please print and fill out the Patient Medical History and Patient Registration and Consent for Treatment Forms directly below.
The Records Release Form is to be used when patients want their medical records sent to us from another medical facility or if they want their records here sent elsewhere or to themselves. Our Notice of Privacy Practices describes the privacy practices of Advanced Dermatology & Cosmetic Surgery Center.
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(Call 330-425-7600 for cosmetic appointments)