Patient Forms, Map and Directions to Our Locations
Your first visit to Michael J Rogers MD involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can also save some time by completing the patient forms in advance of your appointment. For your convenience, you can click any of the links below, fill out all the required fields and click the submit button when you are finished.
Our practice is working together to realize a shared vision of uncompromising excellence in dermatology.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Online New Patient Forms (Please read and fill out all forms in this section)
- New Patient Registration Form (fill out)
- Visit Questionnaire (fill out)
- Notice of Privacy Practices (read only)
Other Online Patient Forms
- Consent to Treat Minor Patient Without Parent/Legal Guardian Present (This form is only accepted for established patients.)
- Authorization and Release to be Photographed
- MicroNeedling or MicroNeedling with PRP Consent Form for a Minor
- Prescription Refill Request Form (This form is only accepted for established patients.)
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.