- Patient Registration Form (Part 1)
- Patient Registration Form (Part 2)
- Rockledge Medspa Registration Form
- Records Release Form – Incoming to Dermatology Center
- Records Release Form – Outgoing to Patient or Outside Physician
- Patch Testing/Contact Dermatitis Evaluation Form
- Notice of Privacy Practices
- MOHS for Rockledge Surgery Center
- Excisions for Rockledge Surgery Center
As a courtesy to our other patients, if you arrive late for your appointment we may have to re-schedule you for another day. We recommend that you arrive at least 15 minutes early to find parking and find our office, or arrive 30 minutes early if you also need to complete patient forms in the office. Please call us if you will be late and we can let you know if your appointment needs to be re-scheduled. For surgical appointments it is extremely necessary to arrive on time. For all appointments plan to be in our office for at least an hour, and please schedule your day accordingly.
Acne Treatment Patient Policy
All acne patients with Esthetician appointments must be on time for their acne appointments. There is no grace period for late arrivals for this particular treatment. We advise that you arrive at least 10 minutes early to account for parking. If you are late for this appointment a $25 fee will be charged and we will have to re-schedule your appointment. We are implementing this policy as a courtesy to all of our patients, so that their appointments run on time.
All balances shall be paid in accordance with each client’s payment arrangement. A Processing fee equal to 10% of the Contract will be charged against your total purchase if canceled after 72 hours. No refunds will be made for cosmetic services after 14 days; however any unused credits may be applied toward other cosmetic services or purchase of skincare products. If the contracted treatment package is not completed, the single treatment price will be charged for all completed treatments, in which case The Dermatology Center will have no further obligation to complete remaining treatments. For any treatment package, treatments must be completed within one year of the first treatment.
The building charges for parking at all times. You can use credit cards as well as cash now, and pay in the lobby before heading back to your car. Unfortunately we do not validate parking.
Non Prescription Products and Makeup – Unopened
- Full Refund with sales receipt if returned in new condition within 15 days of purchase with receipt.
- Store credit given if returned in new condition, unexpired without receipt within 15 days of purchase. Store credit may be used toward purchase of skin care products or cosmetic services.
Non Prescription Products and Makeup Products- Opened
- If opened and minimally used, may be returned within 15 days of purchase for a store credit of 50% of the value.
- Nonprescription products may not be covered by flexible spending plans, due to lack of medical necessity.
- No return is allowed by Maryland law
- Prescription products include
- Tretinoin (all strengths)
- Open Jane Iredale makeup returns are accepted up to 15 days of purchase, ONLY if the product was defective or the patient had a reaction to the makeup.
- UNOPENED, NEW CONDITION returns are accepted within 15 days of purchase with receipt.
- All other returns will not be accepted.
The only way to ensure your product is genuine is to purchase it through an authorized medical practice. It is not guaranteed that the product quality or authenticity of products purchased through any other outlet is authentic.
For any questions about the skin care products or packages you have purchased, please contact any of the following:
Denise West at 301-968-1212 or at email@example.com
Lauren Mueller at 301-968-1214 or at firstname.lastname@example.org
Tara Elton at email@example.com
Jennifer Furlow at 202-244-4550 firstname.lastname@example.org
Promotional items are non-refundable.