About Us Staff Patient Forms Contact Us

Our Services Medical Dermatology Cosmetic Dermatology Aesthetician Services Which Procedure is Right for Me? Reasons to See Our Doctors Payments and Financing Patient Forms

Laser Skin Care Center

Virginia Hills Medical Center
3918 Long Beach Blvd., Ste 200
Long Beach, CA 90807

Telephone (562) 997-1144
Fax (562) 997-9881

Laser Skin Care Center Dermatology Associates Forms

Patient Forms

Please download, print, and fill out these forms prior to your first visit and bring them with you to Laser Skin Care Center or email the forms to lyn@lasercarespecialists.com to Laser Skin Care Center:

FIRST-TIME PATIENT FORMS Download and complete PDF then submit via email or print out and bring with you on your visit to Laser Skin Care Center	288 K	DOWNLOAD »
CARECREDIT® PDF APPLICATION* Download and complete PDF and bring with you on your visit to Laser Skin Care Center	104 k	DOWNLOAD »
CARECREDIT® ONLINE APPLICATION* Apply online on the CareCredit website		ONLINE FORM »

*Please complete Care Credit application for 12 month, no interest financing or 24/36/48 months with interest financing. The 12 month program has a $300 minimum charge with the other programs having a $1,000 minimum charge.