Patient Information

New Patient Registration

Your First Step

Complete a New Patient Registration Packet.  Please download and complete these forms ahead of time. You may fax the completed forms to our office at (916) 784-7548 or email them to frontdesk@rosevillederm.com.

If you are unable to complete these forms prior to your appointment, please arrive 20 minutes early to complete them.

Your First Appointment

What to bring:

1. New Patient Registration Forms
2. Insurance card
3. Photo ID
4. List of medications

• If you are scheduled for a skin cancer check or laser treatment, do not wear make-up to your appointment or be prepared to remove your make-up.
• Children under 18 must be accompanied by a parent or legal guardian.

Directions and Map ›

Insurance Plans

• We accept all PPOs, Tricare, and Medicare.  
• We do not accept MediCal, HMOs such as Sutter Independent Physician, Western Health Advantage and Hills Physicians

Financial Policy

• Co-pays must be paid at the time of service.
• Keep in mind that your insurance policy is basically a contract between you and your insurance company. You are ultimately responsible for the payment of services.
• If we are not contracted with your insurance carrier, you are responsible for payment in full at the time of service.
• Not all insurance plans cover all services. In the event your insurance plan determines a service to be "not covered," you will be responsible for the complete charge.

Missed Appointment/Cancellation Policy

We respect the value of your time and ask the same of you.  If you need to cancel your appointment, we request that you call our office at least 24 hours in advance so that we may offer this appointment time to another patient (we often have a long “cancellation” waiting list for patients who want to be seen).  We reserve the right to charge a $25 fee for a missed medical appointment and a $75 fee for a missed surgical or cosmetic appointment.

Cosmetic Procedures

There is a $75 fee for cosmetic consultations with one of our providers. This fee is fully credited toward any cosmetic procedure or any skin care product. All cosmetic procedures require a deposit of at least $75 and payment in full at the time of service.  Your $75 deposit will be assessed if you “no-show” your appointment.

Notice of Privacy Practices

As required by the privacy regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Download our Notice of Privicy Practices ›