Skin Patient Information
NEW Patient printable forms:We ask that our "new patients" print and complete the following form and bring them with you to your first office visit.
New Patient Form
Forms for existing patients:Please use these printable forms to update medical information before your next visit. We've also included post-procedure instructions for a number of popular treatments.
Existing Patient Form
HIPAA notice:We care about your privacy! This printable form explains how we safeguard your health and medical information.
Health Insurance Portability And Accountability Act (HIPPA) Notice of Privacy Practices form
Appointments:Late cancellation or missing an appointment often keeps Dr. Downie from seeing someone in need. We have instituted a policy to discourage this. Failure to give 48 hours notice of cancellation for an appointment or a procedure can result in a charge of $50 or more being placed on your account. This charge cannot be billed to your insurance company. Three missed appointments can result in the patient being discharged from image Dermatology.
Health Care Participation:
- Aetna US Healthcare
- Atlantic Health System (AHS)
- Great West
- Qualcare PPO & HMO - We Do Not Take Solaris or Health Republic.
- Mountainside Hospital Employee Health Plan (administered by Blue Cross Blue Shield of New Jersey)
- Now accepting Blue Cross Shield
- No longer accepting Health Republic under Qualcare or any other company.
Medicare/Medicaid Participation:I participate in Medicare. I do not participate in Medicaid.
image ConsultationAt your initial image consultation, we will address your cosmetic and medical concerns about your skin¹s present condition and create a personalized regimen to help you achieve your goal of creating an optimal image.
Dr. Downie is a strong promoter of Skin Cancer Screenings on behalf of the American Academy of Dermatology. As the incidence of skin cancer is increasing at an alarming rate, image Dermatology offers comprehensive total body skin exams. These screenings check for moles and allow for early detection of both precancerous and cancerous lesions. These exams should be performed at least once a year and we respectfully request that all of our patients have one.
Prescription Refills:Your medical record must be available to the doctor when refilling your prescriptions. Any significant medical changes will be noted in the record at the office. Therefore, prescriptions will only be refilled during office hours.
Payment and Insurance:Payment is due when our services are rendered. There is a consultation fee for the initial visit. Cosmetic or surgical procedures performed during office visits incur separate additional charges as do skin care products. We accept cash, personal checks, American Express, Visa and MasterCard. Our biller will be happy to assist you in any way possible to ensure that you obtain maximum reimbursement from your insurance carrier for covered services.
At image Dermatology, our office hours are structured to facilitate in office cosmetic procedures. As they require extended visits, we regret that you will be billed for any missed/cancelled cosmetic procedures not rescheduled at least 48 hours prior to the appointment time.
Managed Care Patients:Please bring your insurance card and a referral form that has been properly authorized from your primary care physician (if required by your plan)
Emergency Calls:Dr. Downie is always available to you for true medical emergencies. If you have a medical emergency, please call the office at (973) 509-6900 and listen to the emergency instructions.
The office staff is also present on Monday from 9:00am to 1:00pm for scheduling appointments, prescription refills and laboratory test results.
Call today to set up a consultation. (973) 509-6900
No-Show/ Missed Appointments
- If you are unable to make it to your next appointment, please inform to us before 48 hours of your appointment.
- No-show/missed appointments are subject to a cancellation charge of $50 or more.