Please read carefully, fill out and sign ALL the forms listed below in order to expedite your registration prior to your initial scheduled appointment at Bergen Dermatology.
- New Patient Form
- Credit Card Authorization Policy
- PHI Consent Form
- Financial Disclosure Form
- Cancellation Policy
- Meaningful Use Form
- Pharmacy Policy
- Financial Agreement for Cosmetic Procedures
Bergen Dermatology currently participates in the following plans:
*Please note: Charges not covered by your insurance company, as well as applicable copayments and deductibles, are your responsibility and will be collected at the time of service. We do not accept student insurance plans and please call us with any questions regarding in and out-of-network insurance participation.
We do not accept Amex.