Patient Forms

We value your time!

The Medical History & Registration forms are available for new patients to download, print, and complete prior to the first visit.

 Patient Forms & Policies 

Notice of Privacy Practices

Registration Form 

Prescription Refills Form  

Consent to Treat a Minor  

Medical Records Release to another Physician 

Medical Records Release from another Physician 

Please fax a completed Medical Records Release form to our office at (832) 871-4112 , or scan it and send it to staff@yourclearskin.com . We will be more than happy to transfer records as soon as possible to facilitate your medical care. Please note that a fee may apply for obtaining records for personal use or other purposes (such as life insurance policy determination).

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 Click here to download it.