Patient Forms
Basko Dermatology is thrilled that you have chosen us for your dermatological needs. Please note the following information regarding your appointment with us.
- Prior to your first appointment, please make sure to read and familiarize yourself with the forms below. You will be signing them electronically when in the office.
Download Forms
- Upon making your first appointment, a Portal link will be sent to your email address with information on how to complete your medical history online prior to your appointment.
- Please arrive 15 minutes prior to your appointment time.
- Please bring the following items/documents with you at your appointment:
- Valid Photo ID
A valid photo ID is required to verify your identity. You cannot be seen for your appointment and will be asked to reschedule if you do not have a photo ID with you. - Current Insurance Card
A valid insurance card is required in order for us to submit claims to your insurance. If you do not have an insurance card, then you will be self-pay and required to pay in total at the time of service. - Valid Credit Card
A valid credit card is required at the time of service. Our office will predetermine the amount that you as a patient are responsible for based on your insurance plan. Co-insurance amounts, deductibles, and all noncovered items and charges are due at the time of service (please refer to our ‘Financial Policies’). Your claim will be submitted to your insurance. - List of Current Medications
- Valid Photo ID
- You will complete the Patient Registration process upon check in to our office.
- Should you have any questions prior to your appointment, please call us at 630-596-8045. Our staff are happy to assist you to make this process as seamless as possible and your experience with us enjoyable.