Filling out form - Dermatology Associates of York, PA
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Appointment Cancellation Policy

Thank you for trusting your medical care to Dermatology Associates.  To better serve our patients, we have instituted an Appointment Cancellation Policy.   A cancellation made with less than a 24 hour notice significantly limits our ability to make the appointment available for another patient who needs our care.

Should you need to cancel or reschedule an appointment, please contact our office as soon as possible, and no later than 24 hours prior to your scheduled appointment.  This gives us time to schedule other patients who may be waiting for an appointment.  A message can always be left on our voice mail to avoid a cancellation/no show fee from being charged.

Any uncancelled or missed appointments will be charged a no show appointment fee ranging from $25 to $50.  This fee is not billable to your insurance. 

Please also note that if you are 15 or more minutes late for your appointment, the appointment may be cancelled or rescheduled. 

As a courtesy, we make reminder calls for appointments one to two days in advance.  Please note, if a reminder call or message is not received, the cancellation policy remains in effect.

Repeated missed appointments may result in termination of the physician/patient relationship. 

If you have any questions about this policy, please let our staff know and we will be glad to clarify any questions you may have.


Health History Form Options

Please fill out a Health History Form and bring the completed form with you to your appointment – alternatively, you could go into our “Patient Portal” and fill out the form there.  Please see the instructions for both options here below: 

1)  Print out your Health History Form using the following link and bring the completed form with you when you come for your appointment: Health History


2)   Complete the Health History Form electronically through Patient Portal Log-in.

For information about the Portal Page click here      

The following forms are for informational purposes and will be signed electronically in the office at the time of your appointment:

Notice of Privacy Practices

Consent & Authorization

Communication Consent

Medicare Authorization

Non-Participating Insurance Authorization

Participating Insurance Authorization

Medical Records Release

Consent for Medical Photography Options

Patients will be asked to complete a “Consent for Medical Photography”.  You may either print this form from home using the following link and bring it to your appointment or you may complete it when you arrive for your appointment.


Service Animals

Dermatology Associates of York recognizes the need for service animals to accompany patients, at certain times, to their appointments in our facilities.  To that end, we are committed to reasonable accommodations where the presence of the service animal does not interfere with the ability of our staff to provide care or jeopardize the safety or wellbeing of others.

 Emotional Support Animals

Due to the nature of our specialty, we are not able to accommodate an emotional support animal (ESA).


Pets (domestic or tamed animals kept for companionship but that are NOT documented service animals) are not permitted in our facilities.