DermHouse
DermHouse

Where to Find Us:

DermHouse                          

29425 Northwestern Hwy   

Suite 202                         

Southfield, MI.  48034   

Phone:  248-219-7007

Fax:      866-410-6205

Contact email:  doctor@dermhouse.org

We are now 3 years into operations!! Whave seen over 600 patients. Despite the Affordable Health Care Act, many people still are uninsured or underinsured.  Our goal going into the uncertain 2017 is to continue to service the needs of the people who need our help!

Contact Us

 

Patient Forms            If you are a new patient, please make sure to complete the patient registration forms below.  You can download them and fill out before your first visit.  If you forget, don't worry, we have extras :)  These are located on the Home page and the Appointment page.

Get Social With Us

Appointments and Forms

Operations will begin January 4, 2014, initially on Saturday mornings, with the eventual goal of adding Fridays.  The clinic will be appointment based.  Depending on the response of the community and needs of our patients, we will try to accomodate all who are in need of these services.

At this time, the best way to obtain more information is by sending us a message.


First-time visitors are required to fill out the new patient registration form, which can be downloaded and printed out in advance using the download link on the left lower area of this webpage.  They are available in PDF and Word versions.  Soon you will be able to fax or email these back.  Don't worry, we have plenty of these forms at the clinic in case you forget or do not have access to these on the internet.

We hope to help in any way we can.   DermHouse



New Patient Form 'A' Word Format
dermhouse new patient form A.docx
Microsoft Word document [51.4 KB]
New Patient Form 'B' PDF Format
dermhouse new patient form A.pdf
Adobe Acrobat document [65.1 KB]
New Patient Form 'B' Word Format
dermhouse new patient form B.doc
Microsoft Word document [92.5 KB]
New Patient Form 'B' PDF Format
dermhouse new patient form B.pdf
Adobe Acrobat document [105.5 KB]
HIPAA Privacy Notice DermHouse
dermhouse hipaa 12-2013.pdf
Adobe Acrobat document [140.9 KB]

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