Patient Forms - The Skin Care Center

New patients for our Skin Care Center will still register by printing and completing the forms above.

Below you will find several forms we will need for registration. Please take a few minutes to print them out and complete them. 

To view the following "Download/Print" forms, please download the latest free version of Adobe Reader. get adobe reader

Welcome Form: Download/Print

Client Skin Care Questionnaire:  Download/Print

HIPAA Notice: Download/Print

Patient Notices and Authorizations: Download/Print

Map: Download/Print

Payment for services and products will be collected at the time of the appointment. For your convenience we accept Visa, MasterCard, and Discover. See our payment options for more information.

  • microderm
  •  facial
  •  SkinCare2
  • "Ardie taught me how to use make-up to de-emphasize the effects of the natural aging process."

    ~ Marcia Doty

  • "I am 110% satisfied and have much more confidence. I receive compliments on my clear skin and make-up a lot."

    ~ Laura Doty

  • "Within two treatments the 'mask' I had from pregnancy was gone! Ardie understood what I needed, listened to me and took care of my problem areas."

    ~ Heather Johnson