Forms

Forms

We would like to help improve the quality of your experience at our practice. 

You can download our forms and fill it out before coming in for your appointment.   This will help expedite your visit when you arrive at our office. 

Please fill out all forms in black ink.  Thank you.


New Patients - Please print and fill out the Patient History and the Privacy Protection Agreement (HIPAA) forms

Patient History

The Patient History Form is for all new patients and those who have not filled one out in the past year.  
Patient History form - Click here to download and print.

Privacy Protection Agreement (HIPAA) form



Authorization for Treatment Consent of a Minor

This form authorizes listed adults (other than parents) to bring minors in for treatment.
Consent for Treatment of a Minor form - Click here to download and print.
 

Aesthetic Services

Prior to your visit with our aesthetician, you can improve the quality of your experience and save time by filling out this patient profile form.

Aesthetician profile form - Click here to download and print.


Palm Beach Gardens Office
600 Village Square Crossing
Palm Beach Gardens, FL 33410
Phone: 561-694-9493

Water’s Edge Dermatology is a medical and cosmetic dermatology practice serving adults and children for diseases of the skin, hair and nails, and offering services including skin cancer exams, skin cancer screening and check ups, skin cancer detection, skin cancer treatment, mohs surgery, Botox, Dysport, fractional CO2 laser skin resurfacing, injectable fillers (Juvederm, Restylane, Radiesse, Perlane, & Sculptra), laser hair removal, IPL photorejuvenation, treatments for sun damage, and laser vein treatment. Products offered to enhance your beauty are Wederm, Obagi, Neocutis, iS clinical, Latisse, Jane Iredale and Colorescience.

From the office locations throughout Florida (see Contact Us page), we serve the following areas: North Palm Beach, West Palm Beach, Riviera Beach, Juno Beach, Jupiter, Tequesta, Lake Park, Mangonia Park, Palm Beach, Singer Island, Lake Clark Shores, Palm Beach Shores, Lantana, Boynton Beach, Greenacres, Atlantis, Palm Springs, Lighthouse Point, Pompano Beach, Ft Lauderdale, Belle Glade, Royal Palm Beach, Wellington, Acreage, Pahokee, Hobe Sound, Palm City, Sewall’s Point, Port Salerno, Indiantown, Jensen Beach, Hutchinson Island, Jupiter Island, Rio, St. Lucie West, White City, Lakewood Park, Vero Beach, Oslo, Ocean Breeze Park, Labelle, Lake Placid, Moore Haven, Avon Park, Wauchula, Venus, Lorida, Micco, Vero Beach, Palm Bay, Florida Ridge, Melbourne, Kings Point, Boca Raton, West Melbourne, Deerfield Beach, Sandalfoot Cove, Palm Springs, and Frostproof. Florida.

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