Preparing for Your Visit
The entire staff at Commonwealth Dermatology aims to see our patients in a timely manner because we care about your time. In addition to completing the forms below, we also ask the following:
* PATIENTS UNDER THE AGE OF 18 MUST ARRIVE WITH A LEGAL GUARDIAN
* Please arrive 15 minutes early prior to your scheduled appointment time
* Please bring your insurance cards, photo ID, and any applicable referral
* Any copay, coinsurance or deductible is collected at the time of visit.
* If you are unable to make your appointment please provide 24 hours notice by calling or sending a portal message. Failure to do so could result in a $50 no show fee.
General Dermatology:
We've made it easier to register for your visit by offering our forms online! Simply complete the forms below and bring them in at the time of your visit.
**Currently our online forms are not accessible. For your convenience, you can print off the PDF packet to complete and bring to your visit.**
Please Complete these forms if you have not been seen within the current calendar year or changes have occured
Referral Information:
Patients being referred to Commonwealth Dermatology will need to have this form completed by the referring provider. Attach this form to all corresponding documentation and fax to the practice, 804-288-7135, prior to your appointment
Medical Records Form:
Insurance
Commonwealth Dermatology participates with the following insurance companies:
- Aetna - PPO, American Continental
- Anthem BC/BS & Healthkeepers
- Cigna - PPO, Health & Life, Great West, Mid-Atlantic
- MDIPA Optimum Choice UHC
- Medicaid - Straight, Aetna Better Health
- Medicare -
- Medicare Advantage PPO's - Anthem, Humana, United HealthCare
- Railroad Medicare
- Optima Health Plans (Sentara) - Commercial
- Humana Military Tricare
- Tricare for Life
- United Healthcare
- Multiplan including Private Healthcare Systems (PHCS)
- Virginia Health Network
- GEHA
- Humana HMO
- Anthem Medicare Advantage HMO
- ALL Bon Secours Mercy Health Plans (Medical Mutual of Ohio)
