Patient Forms & Policies

Patient Forms

Patient Portal

Patient Portal


To gain access to our patient portal, please register with our office. You may click on “Message us” on the bottom right corner of this screen or call/text our office at 972-548-0333. Registration requires DOB, name, address and email.

Please login to our Patient Portal, and go to the “My Health” section. Please fill out the following: Contact Info, Insurance & Pharmacy, Medications, Past Medical History, Skin Disease History, Social History, Quality Measures, Implantable Devices, Family History and Problem List.

You may also download the APPatient app to complete the information for the patient portal. For Telehealth and eVisits, please use the APPatient app.

If you do not complete the information via the Patient Portal, please arrive at your appointment 20 minutes in advance.

 

Appointment Scheduling Details


We know you have many choices when choosing a dermatologist, so we have made requesting an appointment a simple and convenient process via our website. If, for any reason you cannot keep a scheduled appointment, or will be delayed, please notify the office as soon as possible by clicking “Message us” at the bottom right of this screen or calling/texting 972.548.0333. This will allow us to better serve our other patients.

If you are a new patient, please be ready to provide your name, date of birth, insurance carrier and identification number, as well as the purpose for your visit. Providing us with this information beforehand will help increase our efficiency and will provide you with the appropriate appointment length. If you have a managed care insurance plan, it is your responsibility to obtain a valid referral. You may have to reschedule the appointment if the referral is not in place at the time of visit.

Please update us with your new address, current health insurance and any other changes in demographic location.

If you cannot keep your scheduled appointment, please call the office at least 24 hours in advance to avoid a fee being charged to your account.

In consideration of other patients, if you are more than 15 minutes late, it may be necessary to reschedule your appointment or wait until our staff can accommodate you. We certainly take traffic and weather into consideration.

Cell phones are permitted but please be courteous to our staff and those around you. To ensure patient privacy, photography and/or videography are not permitted without written authorization from the patient and Dr. James Ralston.

If you are under the age of 18, a parent or guardian must be present at your initial visit. A minor consent form can be signed if there is a need to make accommodations to be seen alone in the future depending on the nature of the visit.

 

No Show/Reschedule Policy


We understand that there are times when you must miss an appointment due to emergencies or obligations for work or family. However, when you do not call to cancel an appointment, you may be preventing another patient from getting much needed treatment. Conversely, the situation may arise where another patient fails to cancel and we are unable to schedule you for a visit, due to a seemingly “full” appointment book.

If you are unable to keep your scheduled appointment, please notify us at least 24 hours in advance so we can accommodate our other patients. You may also reschedule your appointment at that time. Our no-show policy is as follows: a 24-hour notice is required (this may include a voicemail left on our phone system). After the first no-show appointment, you will receive a phone call to remind you of the missed appointment and to reschedule your appointment.

You will be charged $50 ($100 for surgeries or cosmetic treatments) for the time slot we were not able to fill when you were a no-show. Appointment cancellations made under 24 hours will be billed a $50 cancellation fee. On the third no-show or reschedule without at least 24 hours notice, it will be the physician’s discretion as to whether a discharge letter will be sent out disengaging you from the practice and giving you 30 days to enroll with a new physician. To help prevent you missing your appointment and being charged a no-show/rescheduling fee, as a courtesy, we offer email reminders, text reminders, appointment reminder cards, and phone call reminders. However, these are offered as a courtesy and failure to receive an appointment reminder does not exclude you from being subject to our no show policy.

The patient is ultimately responsible for all professional fees

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