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Patient Forms


Pre-Registration Process

2-3 days prior to your scheduled appointment you will receive an email and/or text message letting you know it is time to complete your online pre-registration. By clicking the link in the message, you will be taken to the check-in portal where you will answer questions and complete the electronic forms. If you have a required co-pay, you will make payment during this pre-registration process. Once this is completed, you will just need to arrive at the office a few minutes prior to your scheduled appointment time, and you will already be considered checked-in and ready to be seen by your provider.

If you do not wish to register electronically, you may choose to print the appropriate Registration Packet below and bring the completed forms to your scheduled appointment to provide at check-in.

If you are unable to complete either electronic check-in or the printed forms, please arrive at our office 15 minutes early so you have time to complete the forms we provide you before your scheduled appointment time.

     New Patient Registration Packet for Adult

     New Patient Registration Packet for Minor

     Existing Patient Registration Packet

HIPAA Privacy Notice

What to Expect at your Annual Skin Cancer Screening (Full Body Skin Check)

Hair Loss Questionnaire Form


Please use the links below to review pre and/or post instruction guidelines for your scheduled procedure:

AviClear Pre-Post Instructions

BBL Hair Reduction Pre-Treatment Instructions

BBL Hair Reduction Post-Treatment Instructions

BBL Photofacial & SkinTyte Pre-Treatment Instructions

BBL Photofacial Post-Treatment Instructions

BBL SkinTyte Post-Treatment Instructions

Botox Post Tx Instructions

Chemical Peel Pre & Post Treatment Instructions

Fraxel Dual Pre-Treatment Instructions

Fraxel Dual Post-Care Instructions

Hydrafacial Pre-Treatment Instructions

Lamprobe Post-Treatment Instructions

Microneedling Pre & Post Treatment Instructions

PRP for Hair Restoration Pre-Treatment Instructions

PRP for Hair Restoration Post-Treatment Instructions

Tretinoin Retin-A Care Instructions

Vi Peel Pre & Post Treatment Instructions




Warrenton Dermatology & Skin
Therapy Center

28 Blackwell Park Ln, #302
Warrenton, VA 20186

Phone: 540-701-4656

Fax: 540-341-0940

Office Hours
  • Monday

    8:00 am - 4:15 pm

  • Tuesday

    8:00 am - 4:15 pm

  • Wednesday

    8:00 am - 4:15 pm

  • Thursday

    8:00 am - 4:15 pm

  • Friday

    8:00 am - 4:15 pm

  • Saturday


  • Sunday


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