Parental/Guardian consent for treatment of a minor. (Must also send copy of parent/guardian Photo ID)
Referral from PCP (Rarely required by insurance, but important if your insurance requires it. Otherwise you may be responsible for your bill if your insurance denies the claim due to lack of referral)
Records Release Forms:
Request an Appointment
Bravia Dermatology is committed to excellent care for our patients. We offer comprehensive medical, surgical, and cosmetic dermatology care.
For your convenience, you may submit the request appointment form, and a member of our staff will reply shortly to schedule your consultation. We will do our best to accomodate your appointment preferences. We accept Medicare and most commercial insurance plans.
If you are experiencing an urgent issue, please do not contact us through our website. Call our office directly at 419.948.DERM (3376)