Patient Forms


Please click on the link for the form(s) you need to complete. New patients should click on the “New Patient Packet” link. Existing patients may update forms as needed when their personal information or medications have changed by clicking on the appropriate link.

Each document has required and optional information. A RED ARROW will indicate which information is required. If you don’t have a response for required information, place an N/A or state “none”. In most cases, you will be asked to sign the form when you come into the office for your appointment. For the Medical Records Release form, you will need to sign it with your mouse or touch screen. Once complete, please click on the submit button at the bottom of the page. The process in not yet complete. You now need to check your email. To confirm your identity, please click on the CONFIRM DOCUMENT link in the email. The forms will automatically be sent to our office in anticipation of your appointment.

Alternatively, you may print the forms here, and bring them with you on the date of your appointment.

We look forward to seeing you soon.

Patient Forms Packet
Medical Records Release
Patient Medication Record
Patient Information Form
Insurance Information
Covid-19 Questionnaire
Office Policies

HK Dermatology
30280 Rancho Viejo Rd.
San Juan Capistrano, CA 92675
Phone: 949-248-1632
Fax: 949-248-9339
Office Hours

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