Dear Patient,

To better serve our patients we have taken the time to provide digitized forms that can help you prepare for your upcoming telemedicine consultation. Clicking on the appropriate link will take you to the form, which you can then complete before your consultation.

These are digital forms so you are able to fill them out directly on your computer, then email them back to us without any need for printing.

When sending your insurance information, please be sure to include a photo copy of the front and back of your insurance card.

 

Looking forward to seeing you soon!

Dr. Hall & Staff

 

Forms

HIPAA Form

Patient Health Information Form

Patient Intake Form

Telemedicine Consent Form

*Must be on a computer. To use the digital forms, begin by downloading the form to your PC and saving them to your documents not downloads. It’s important to save them first to your documents before filling them out. If you do not do this important step some programs will erase the information. Then search for the file inside your documents. Then fill out the information, save it to your PC, and send it back to us. Please let us know if you have any questions!

 

Consult Cancellation Policy

Dr Hall charges a fee for his cosmetic consultation that helps to defray the cost of seeing you in the office. The time to see you is reserved. The fee is charged by credit card at the time of booking your appointment. We understand that plans may change and this is fully refundable if canceled 5 or more business days before.