Carolinas Dermatology Group, P.A. | Patient Forms and Resources

Patient Forms and Resources

Forms can be completed by either entering the information directly into the form and then printing it out, or printing out the blank forms and then writing in your information.

Please be sure to bring the completed paperwork to your appointment, along with your photo ID and your insurance card(s).

Please arrive 15 minutes earlier than your scheduled appointment time to complete registration with us.

New Patient Form:
Download New Patient Form

MOHS New Patient Form:
Download MOHS New Patient Form:

Medical Records Request Form:
Medical Records Request Form:

Credit Card Authorization Form:
Credit Card Authorization Form:

Appointments & Cancellations

Office Hours: Patient appointments are generally available from 8:00 am to 4:00 pm Monday through Thursday and 8:00 am until 11:50 am Friday, depending on each provider’s schedule. Appointments: For your convenience you [...]

Accepted Insurance & Payments

We participate with the following insurance companies: Medicare, Tricare, BC State, BCBS of SC, BC PPO, Federal BC, Blue Choice, Aetna, Cigna, United Healthcare, MedCost, Coventry, and Supermed. There may be several other carriers not listed. (Disclaimer: Although the list is currently accurate, our participation status may change at any time. Please confirm our status with your carrier when making your appointment.)

Notice of Privacy Practices

At Carolinas Dermatology Group, P.A., we are committed to protect the privacy of your personal health information (PHI). This Notice of Privacy Practices describes how we may use within our practice or network and disclose (share outside of our practice or network) your PHI to carry out treatment, payment or health care operations. We may also share your information for other purposes that are permitted or required by law.

Prescription Refills For Carolina Dermatology Group, P.A. Patients

Refill Requests: Refill requests will be handled by our staff. Please contact us at 803-771-7506 with your refill request. Please be sure to have your prescription number and preferred pharmacy information readily available [...]