Patient Forms

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.

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, Medicare and Medicaid plans.


  • My experience surpassed my expectations. She answered all my questions and gave me multiple options for my treatment.
  • Dr. Boakye was wonderful! She is professional and personal and I did not feel the least bit hesitant to take my time asking questions. The office is clean and building has parking.
  • Dr. Boakye is so friendly and helpful with your medical issues. She was not in a rush and really listened to your concerns. I highly recommend Dr. Boakye.
    — Tanya W.