Forms | Spicewood Derm

Spicewood Forms

This section of the Spicewood Dermatology website offers three main categories for patients: "I'm a New Patient," "I'm a Current Patient," and "It's Been a While." Each category provides tailored forms or information depending on the patient's status, making it easier to connect with the clinic, schedule appointments, or access the relevant services.

Appointment Forms

New patients, and patients who have not been seen in 3+ years, will need to complete this set of forms before their first appointment.

MUST arrive 20 minutes early to complete these forms in our office.

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Minor Consent Form

If a patient is under the age of 18 years, they must be accompanied by one or both parents at the time of the visit(s).

This consent form must be filled out by a parent to appoint a responsible adult (18 years or older) to act as a guardian in place of the parent.

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Authorization to Release Records

This form must be completed if you'd like to request your medical information be released to another party.

Please allow 24-48 hours for records to be reviewed by our Providers.

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Authorization to Receive Records

This form must be completed if you'd like Spicewood Dermatology to receive your medical information from another party.

Please allow 24-48 hours for records to be reviewed by our Providers.

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Patient Portal

We are excited to introduce a new secure connection for our patients to access their personal health information and send messages. If you do not have your Patient Portal username and password, please contact our office first to obtain your username and password. Please do NOT attempt to register through the Patient Portal. This is very important. If you are already registered for the Patient Portal, please click the button below to log in.