Patient Forms & Policies

What you need to know before your appointment with Chicago’s preferred dermatologists.

Empowerment through transparency.

What to Know Before Your Dermatology Appointment in Chicago, IL

It’s important to each of us at Skin MD that our patients are informed, confident, and completely aware about the entire care process. We strive for utmost transparency in our billing, scheduling, services, and pricing. When you know all there is to know about the care you’re getting, you can focus better on healing and moving forward.

Browse our patient policies below and reach out with any questions. You can call us today at 708-636-3767 or contact us online. Find a Skin MD location in a Chicago neighborhood near you or get answers to common questions on our FAQs page.

Medical No-Show Policy

We kindly ask that you provide at least 24 hours’ notice if you need to cancel or reschedule your appointment. Failure to attend a scheduled appointment without prior notice will result in a $50 no-show fee. Repeated no-shows may affect your ability to schedule future appointments.

708-636-3767

The No Surprises Act & Good Faith Estimates

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, healthcare providers must give an estimate of the bill for medical items and services to patients who don’t have insurance or who are not using insurance

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit the Centers for Medicare & Medicaid Services.

Notice for Pediatric Dermatology Patients & Guardians

At Skin MD, we want to be a part of how you teach your child to seek care and how to interact with healthcare providers. Children are curious about their treatments, their ailments, and the next steps in their care process.

To treat our youngest patients safely and effectively, we require that all minors be accompanied by a legal guardian. Otherwise, we may not be able to offer the care that our pediatric dermatology patients need.

If you have questions about this policy, please contact us today.

Patient Forms

As of February, 2023, Skin MD has migrated our patient forms and filing to an electronic medical record system. As a result, all patient forms must be completed electronically in our office. We apologize for any inconvenience.

Cosmetic Procedures

Some of the procedures performed in this office are considered cosmetic with regards to medical insurance. Cosmetic procedures are not covered by health insurance and insurance will not be billed. In addition, no third party (insurance) payment will be accepted.

A cosmetic appointment deposit fee of $25.00 will be collected at the time of booking for all cosmetic appointments. Once service has been rendered in office, the $25.00 deposit will be applied towards your service total.

All cosmetic consultations scheduled with our aesthetician will require a deposit of $25.00 for the consultation. Once aesthetic service has been rendered in office, the $25.00 deposit will be applied towards your service total. If you have decided not to proceed with scheduling a service with the aesthetician after the consultation the $25.00 will not be refunded.

Cosmetic Cancellation Policy
If you are unable to keep a scheduled cosmetic appointment, please give 24 hours advance notice to ensure that you will not be charged for your appointment.

If you cancel within less than 24 hours’ notice a $50 fee will be assessed.

In the case that you no-show for your cosmetic appointment:

For all injectable filler and toxin treatments a $100 fee will be assessed.

For all cosmetic services scheduled with our aesthetician you will be charged 50% of the cost of the service.

More than 3 cosmetic cancellations and fees that have been assessed will require a pre-payment of cosmetic services in full before future appointments are scheduled.

Cancellation of pre-payment package deals will result in loss of any discounts, prepayments and/or credits to your account.

708-636-3767

Cosmetic Cancellation Policy

If you are unable to keep a scheduled cosmetic appointment, please give 24 hours advance notice to ensure that you will not be charged for your appointment.

If you cancel within less than 24 hours’ notice a $50 fee will be assessed.

In the case that you no-show for your cosmetic appointment:

For all injectable filler and toxin treatments a $100 fee will be assessed.

For all cosmetic services scheduled with our aesthetician you will be charged 50% of the cost of the service.

More than 3 cosmetic cancellations and fees that have been assessed will require a pre-payment of cosmetic services in full before future appointments are scheduled.

Cancellation of pre-payment package deals will result in loss of any discounts, prepayments and/or credits to your account.

708-636-3767