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(801) 475-5210

5734 South 1475 East, Suite 300
South Ogden, UT 84403

Patient Forms

Download Wasatch Dermatology Patient Forms

To make your office visit as easy as possible, Wasatch Dermatology has made all the necessary forms and information available to you for easy download. Please complete all of the forms and bring them with you to your first appointment.

We’ll also need your insurance information, medical history, a list of your current medications and your emergency contacts.

If you’re not able to fill out the forms before your appointment, please arrive 20 minutes early to complete them in our office.

To download the New Patient Forms you’ll need Adobe Acrobat Reader™. You can download Adobe by clicking here.

For help with your patient forms or to get more information before your first visit, call 801-475-5210. Learn more about the insurance plans accepted by Wasatch Dermatology by visiting our Insurance page.