Now accepting Telehealth appointments. Schedule a virtual visit.

Registration Forms


 

(Please fill out both forms)

New Patients

Your first visit to Orange Coast Dermatology involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You’ll find all the practical information you need, such as directions to our office, practice hours, and more. Please print and fill out our Patient Registration Forms as well as bring a photo ID and proof of insurance so we can expedite your first visit.

There’s also a dedicated section to our committed staff and our first visit procedures. You can also save some time by printing out and completing patient forms in advance of your appointment.

Mission Statement

Our practice is working together to realize a shared vision of uncompromising excellence in dermatology. To fulfill this mission, we are committed to:

  • Listening to those we are privileged to serve

  • Earn the trust and respect of patients, profession, and community

  • Exceed your expectations

  • Ensure a creative, challenging, and compassionate professional environment

  • Strive for continuous improvement at all levels

1. Registration Form

2. Patient History and Intake Form

Download Adobe Reader

Download both of the blank Forms, complete and save them to your computer.

Then, Please upload and email the forms

to: info@orangecoastdermatology.com

Our Locations

Choose your preferred location