Patient Forms

Thank you for choosing Barrington Park Dermatological Associates, P.C. for your skin care needs. 

You can view, download and print the forms before your appointment at our office.  To download, “right click” on the link using your right mouse button, and “save as” to a location on your computer.

Patient Information

Medical History

Patient Release of Information

Patient Information over 3 Years

Financial Waiver

Medical Record Release Form

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it:

If you have questions, please call our offices at (585) 383-4420.

Thank you.