Patient Forms

Medical History Form-Spanish

HIPAA Acknowledgement Form-Spanish

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. With many cosmetic treatments and smaller procedures such as biopsies, we are usually able to accommodate the procedure the same day as the consultation.

For patients referred for skin surgery, Dr. Mott prefers to have a preoperative visit with you to discuss the surgery and make sure that all of your questions are answered. Please inform us if you have any special medical conditions such as diabetes, high blood pressure, artificial heart valves, history of rheumatic fever, heart murmur, artificial joints, latex allergy, or other allergies.

Please assist us by providing the following information at the time of your consultation:

  • Your referral and biopsy report if applicable.
  • A list of medications you are presently taking, especially heart medications, aspirin or other blood thinners.
  • Your medical insurance card(s) and the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit.

If you are an established patient and would like access to your medical records, please contact our office for your Patient Portal set up.

Office Information

970-669-0159

Boulder

905 Alpine Avenue Boulder, CO 80304
Monday-Friday: 8am-5pm

Loveland
Winter Park

78878 US-40 Winter Park, CO 80482
Wednesdays: 8:00am-4:30pm

Fort Collins
Windsor

1683 Main Street Windsor, CO 80550
Wednesdays: 8:30am-4:30pm

Sterling
Louisville

335 W South Boulder Rd Suite 3 Louisville, CO 80027
Tuesdays and Thursdays: 7:30am-3:30pm

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