Patient Forms & Consents
New Patient Forms
If you are a new patient to our office, please fill out and bring the 2 forms below to your appointment. You may fill them out on your computer electronically or fill out by hand. If you need to schedule an appointment to become a new patient, please contact us at (575) 208-5588.
Please bring your insurance card along with a photo ID at the time of your appointment.
Patient Consent for Procedures
Below is the general patient consent our services. This may include but is not limited to laboratory procedures (including diagnostic testing such as lab draws and skin biopsies), medical and surgical treatment or procedure (including wart treatments, surgical removals, or excisions), or other services rendered during the operation or procedure as described in the consent by the provider. You may fill them out on your computer electronically & print or fill out by hand. We will go over and answer any questions prior to your procedure.
Post - Procedure Instructions
Below are general post-procedure instructions.We will go over instructions at the end of your appointment and send you with a copy of detailed instructions. We are happy to clarify any instructions.
Patient Consent for Isotretinoin
Below is the patient consent for Isotretinoin (widely recognized by the brand name Accutane). You will be enrolled in the iPLEDGE program at your appointment and we will discuss in great detail the risk and benefits of this medication. The iPLEDGE program is a risk management distribution program mandated by the U.S. Food and Drug Administration. Under this program, prescribers must be registered and activated with the iPLEDGE Program and can prescribe isotretinoin only to registered patients who meet all the requirements of iPLEDGE. Isotretinoin can be dispensed only by a pharmacy registered and activated with iPLEDGE. Registered and activated pharmacies can only receive isotretinoin from wholesalers registered with the program. Click the link below for more information.