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Office Policies and Paperwork

What do I need to bring with me to my appointments at Massachusetts Dermatology Associates?

  • Valid photo ID
  • Insurance card
  • Credit card for copay (required at the time of service)
  • A referral from your primary care provider if your insurance requires a specialist referral (if not already sent by your primary care office)
  • For new patients: Completed registration paperwork (see Downloads below)
    • Patient Financial Policies
    • New Patient Questionnaire
    • Receipt of Notice of Privacy and Consent for Release

When should I complete my registration paperwork?

If you have not completed registration paperwork prior to your appointment, please arrive 15 minutes prior to your appointment time to fill out necessary forms.   If we email or mail your paperwork prior to your appointment, please complete and bring it with you. If you did not receive paperwork from us, you may download the necessary forms (see below).

Do I need a referral?

Most HMOs and other insurance companies require a referral.   If you are unsure, check with your insurance company. Please have this faxed to 978-560-1245 prior to your appointment.

What if I am running late for my appointment?

We will try our best to accommodate you, but if you arrive 15 minutes or more after your scheduled visit time, we reserve the right to reschedule your appointment.   If you are running late, please call to let the front desk staff know.

Are there penalties for late cancellations or missing appointments?

If you are unable to keep an appointment, we ask that you kindly provide us with a minimum of 24 hour notice. This courtesy on your part will make it possible to give your appointment to another patient who needs it. In the event that you are unable to give us such notice you will incur a no-show or last minute cancellation fee of $25 for general dermatology appointments and a fee of $50 for any surgical, cosmetic, or aesthetics appointments.

Where can I learn about additional policies at Massachusetts Dermatology Associates?

Downloads below to obtain more information

Useful Downloads

Registration Paperwork

Complete New Patient Paperwork:  This single file contains the New Patient Welcome Letter along with all necessary paperwork for new patients including the *New Patient Questionnaire, *Receipt of Notice of Privacy Practices, and *Financial Policies.   Individual documents (if desired) can be found below, but downloading this file will give you everything you need for your first appointment.

New Patient Welcome Letter: An introduction to our practice with directions to our office, instructions for registration, and policies regarding missed appointments and appointment cancellations.

*New Patient Questionnaire: A brief form that reviews your medical history. This needs to be completed prior to your first appointment.

*Receipt of Notice of Privacy Practices: A consent form that (1) acknowledges your receipt of our HIPPA ‘Notice of Privacy Practices’ (see below), (2) authorizes staff at MassDerm to take photographs that relate to your care, and (3) allows MassDerm staff to share your medical information with designated entities.     This needs to be read and signed prior to your first appointment.

*Financial Policies: An outline of MassDerm financial policies.   This needs to be read and signed prior to your first appointment.

HIPPA Privacy Notice: A detailed explanation of your medically-related privacy rights

*Needs to be completed PRIOR to your first appointment.

Procedural Information / Consent Forms:

BLU-U Photodynamic Therapy (PDT): Procedural information and consent for patients undergoing photodynamic therapy (PDT).   This needs to be read and signed before undergoing treatment.

Narrowband Ultraviolet B Phototherapy (NBUVB):   Procedural information and consent for patients undergoing narrowband UVB phototherapy treatment.   This needs to be read and signed before undergoing treatment.

Patch Testing: Procedural information and consent for patients undergoing patch testing.   This needs to be read and signed before undergoing treatment.

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