Your First Visit

We want your experience to be stress free.  If you like, you can fill out a few forms located to the right of this page before you arrive to save you time during your visit.  May we suggest you sign the "Notice of Privacy Practices Receipt" and fill out one of the "Office Registration" forms (medicare or not-medicare).  If you have any form of insurance but are coming to the office for a cosmetic procedure or consultation, also please read and sign the Advanced Beneficiary Notice (which states you know this is not covered by your insurance plan).

If you would prefer to fill out all these forms in the office, that's fine too!
 

Financial Matters

Payment is expected for all co-pays and deductibles at the time of the visit.
If you have no insurance or are covered by an insurance with which we do not participate, all fees must be paid at the time of visit. We accept payment by cash, check, VISA, Mastercard and American Express. 

Cosmetic and aesthetic services are not covered by any insurance company and we do not submit an insurance form for this.

For your benefit, we participate with CareCredit™, a process by which you may receive an interest-free loan so that you may pay your cosmetic procedures over a period of time.  Just ask us about it or click here to learn more about this innovative financing opportunity:  CareCredit™
 

Insurance

We participate in Medicare and all of the gap insurance secondary to Medicare B.

Here is a list of insurance plans with whom we participate at this time.  This list is not complete and if your insurance plan is not here, please contact our office and we can tell you whether we participate in your plan!

  • BCBS Florida
  • Cigna
  • Humana
  • United Healthcare
  • Aetna
  • GHI
  • MEDICARE


Sorry, we do NOT participate with Medicaid

Schedule a Visit

Thank you for putting your faith in us as your dermatologist.  We welcome you and your family to our family!  Please arrive approximately 15 minutes early in order to complete the necessary paperwork.  We promise to make this as painless as possible.

Call us at (561) 368-1130 and have your insurance card handy for general medical visits.

We’ll call you a day or two prior to your scheduled appointment to confirm the date and time, and we’ll leave a message if necessary.  Please call us back to confirm or reschedule since we do our best to run “on-time” and we can only do so with your cooperation!

Feel free to call us prior to your visit for any questions.  If, however, your question is “how much does it cost?” we hope you will wait for your visit to ask because quoting a price over the phone is like calling a new car dealer and asking them how much a new truck costs: there are so many variables that a quoted price is of little value. Our prices are always reasonable and competitive and we participate in “CareCredit™” to make payments even easier.  At Martin Dermatology, we simply are not in the business to give you the least expensive price:  we are in the business to give you the BEST service at a most reasonable price.

Patient Download Forms

Below are a variety of forms that are relevant to our practice.  Some of them are registration forms and some are consent forms, and some are even instruction before and after treatments.  Download and read or print as you may be interested. 

If you are a new patient to our practice with an appointment, we suggest that you download and print and fill out the form that is entitled "New Patient Registration" and also fill one of the history forms (the Medical History For Cosmetic Procedure if you are specifically coming for a cosmetic procedure; the Medical Questionaire And Chief Complaint for any other patients.  This will save you time in the office!

Please remember to bring your insurance card and a photo ID. Thank You! 

Notice of Privacy Practices

Notice of Privacy Practices Receipt Acknowlegdement Form

Office Registration Form for Medicare Patients

Office Registration Form for Non-Medicare Patients

Advance Beneficiary Notice for Cosmetic/Aesthetic Services for Medicare Patients

Medical Questionnaire Form

Consent for Laser Hair Removal Form

Consent for Laser Treatment Form

Vein Sclerotherapy Information & Forms

Botox or Dysport History and Consent Form

Dermal Filler History and Consent Form (Restylane, Juvederm etc.)


Adobe ReaderAll Downloads Require Adobe Acrobat Reader

 

Call Now for a Consultation: (813) 977-3600 at the prestigious Center for Dermatology and Skin Surgery in Tampa!

Sandy Martin M.D. at Center for Dermatology and Skin Surgery, 14521 University Point Place, Tampa FL 33613
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