54 Scott Adam Rd, Ste 301
Hunt Valley, MD 21030
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Patient Registration Forms

We welcome you to the Maryland Dermatology Laser, Skin and Vein Institute. If you forget the forms, you’ll need to arrive 15 minutes early for your appointment to complete them.

Please fill out the online patient registration form before your visit.
The form is best filled out on a PC with an up to date web browser installed.

Begin online patient registration form 

You may also fill out online the following forms:
 
If you do not wish to fill it out online, you may also print the New Patient Registration Packet, fill it out, and bring with you before your appointment.

Treatment specific forms to print:

For patients who are coming from out-of-town for varicose vein treatments, we encourage you to call to speak with our registered vascular technologist to discuss your personal situation so that we can best schedule your first appointment. Out-of-town patients with varicose veins will need to have time scheduled on their first day for Duplex ultrasound evaluation, so please be sure to mention the size of your varicose veins to the RVT. She can arrange to send you the patient education video and other explanatory forms, if you are unable to view it online. If you can obtain record of previous vein treatments, it is helpful to bring copies with you.

For patients who are coming from out-of-town for laser treatment, please advise the staff when you call for your appointment that you are coming from out-of-town. Most laser treatments cannot be done on a suntanned person and cause a few weeks of sun sensitivity, so keep that in mind when you schedule your consultation. Usually we can only do a test area of treatment with a particular laser (or more than one, depending on the patient) on the same day as the consultation. Again, feel free to ask to speak to one of our staff to give details of your situation so that we can best schedule your first visit. Please keep in mind that Drs. Robert and Margaret Weiss and the Maryland Dermatology Laser, Skin and Vein Institute do not accept any insurance as payment; all treatments must be paid in full on the day of treatment. We will assist you in providing documentation if it is possible for you to obtain insurance reimbursement. Many treatments are not covered by insurance. As of January 1, 2016, MDLSV is now accepting Medicare patients.