BECOME A PATIENT

We look forward to seeing you soon! New patients please complete the online registration form. 


Other forms

Printable New Patient Packet: Click the "New Patient Registration" button to complete the secure online form to become a new patient. Otherwise you can download and print the New Patient Form by clicking here then mail or fax to us 713.952.9448.

Questions about cosmetic services?: Click here to have our cosmetic team specialists contact you regarding your concerns

Medical Release Form:  You may release your medical records from another office to Village Dermatology by completing this Medical Release Form and then you should send a signed copy to the medical office that will be releasing your records to us.

HIPAA Privacy form: print a PDF copy for yourself or you can also  click here to view our policies

Suggestions?  Click here to give us ideas and suggestions