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Palm
Beach Dermatology
John P. Kinney, M.D. & Oren Lifshitz, M.D. |
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Forms |
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Here are a number of forms you may need, either before or after a visit to our office. All the forms are in pdf format, and can be viewed using Adobe Reader.
If you were a patient of Dr. Kinney's at Palm Beach Medical Group AND this is your first appointment in the new office, please print this form, fill it out, and mail it to the Palm Beach Medical Group at 4601 N. Congress Ave, West Palm Beach, FL 33407. If you were a patient of another dermatologist outside of Palm Beach Medical Group AND this is your first appointment with Dr. Kinney or Dr. Lifshitz in the new office, please print this form, fill it out, and mail it to your previous dermatologist's office (Note that the "Purpose of Disclosure" should be marked "Changing Physicians"). If this is your first time to our Medical Center Way office (regardless of whether you were a patient of either physician previously, a patient of any other physician, or have never seen a dermatologist before) please print the following forms and bring them with you for your first visit along with any applicable insurance cards:
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Copyright notice © 2004-2008 Dr. John P. Kinney, M.D.. All rights reserved. |
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