PATIENT INFORMATION

- As of March 1, 2023, image Dermatology ® P.C. will no longer accept checks. -
Thank you for understanding.

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
 Return Visit 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 cancellations or missing appointments often keep Dr. Downie from seeing someone in need. We have instituted a policy to discourage this. Please give 48 hours notice of cancellation for an appointment or a procedure to avoid a charge of $100 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 ® P.C.

Health Care Participation:

  • Aetna Healthcare
  • Allied plans processed under Aetna only
  • Horizon Blue Cross Blue Shield, Omnia Tier 2
  • We are no longer taking new Medicare patients

** PLEASE check with your INDIVIDUAL INSURANCE carrier to ensure that image Dermatology ® P.C., Dr. Jeanine Downie/Megan Kera are in your specific Network/Plan.

Aetna US Healthcare
Blue Cross Shield

Image Consultation

At 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 ® P.C. 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.

Prescriber’s Choice

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, 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 ® P.C., 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 1:30pm for scheduling appointments, prescription refills and laboratory test results.

Call today to set up a consultation. (973) 509-6900

NO-SHOW/ MISSED APPOINTMENTS

Please inform us if you cannot make it to your appointment at least 48 hours in advance. It’s important to note that as of January 2, 2024, our cancellation charges have been updated as follows:

  • If you miss an office appointment without a 48-hour cancellation notice, you will be charged $100.
  • If you miss a surgical appointment without a 48-hour cancellation notice, you will be charged a cancellation fee of $300.

Thank you for your understanding and cooperation.