Patient forms

General forms

• New patient registration forms
• Secure message and file upload
• Medical forms and work documentation request
• Medication access and enrollment authorization

Send or request medical records

Use the authorization form to securely send records to CutisCo, request records from another provider, or send your CutisCo records to another provider.

• Authorization for disclosure of health information

Request records from another dermatology practice

Have your records sent directly to CutisCo from these practices:

• Associates in Dermatology
• Forefront Dermatology
• Pariser Dermatology
• Peninsula Dermatology

Isotretinoin (Accutane) and iPLEDGE

• iPLEDGE informed consents for patients who can get pregnant
• iPLEDGE informed consents for patients who cannot get pregnant
• Home urine pregnancy test result and attestation