FOR NEW PATIENTS:
Prior to your appointment, you will need to fill out the 'Patient Information' form' as well as the 'HIPAA Privacy Acknowledgement' form and email them, along with a picture of the front and back of your insurance card(s) to: info@lwderm.com
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CONSENT FOR EMAIL / TEXT MESSAGE COMMUNICATION OF PERSONAL HEALTH INFORMATION:
If you wish to have our office communicate any of your Personal Health Information (PHI) with you via email or text message, please fill out and email the consent form below to: info@lwderm.com
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FOR EXISTING PATIENTS WITH CHANGES/UPDATES TO INFO OR INSURANCE:
Please email a picture of the front and back of your insurance card(s) along with any other changes (ie, address, phone number, etc) to: info@lwderm.com
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Disclaimer: Please keep in mind that communications via email over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed. Please do not include personal medical information in any emails you send to us. No one can diagnose your condition from email or other written communications, and communication via our website cannot replace the relationship you have with a physician or another healthcare practitioner.
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