150 Broadway, Suite 1110 | New York, NY 10038

Patient Resources

Office Hours

Monday 8:15 a.m – 5:00 p.m.
Tuesday 9:00 a.m – 5:00 p.m.
Wednesday 8:15 a.m – 5:00 p.m.
Thursday 9:00 a.m – 5:00 p.m.
Fridays 8:30 a.m – 4:00 p.m.
Saturdays closed

Forms

FAX: (212) 962-1246
To save time during your first appointment at Goldman Dermatology, fill out these forms and bring them with you. If you have a child under the age of 18 that needs to see one of our dermatologist but can not be accompanied by you please fill out the consent below to treat a minor child. Please note that a new consent form must be filled out for every appointment your child has in our office.

Please remember to bring your insurance card on the date of your appointment .

Click the above link to download the Medical Records Request form. Fill out the information you would like us to provide you and then mail in the request or fax to 212-962-1246.

Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.


Insurances Accepted

We are in network with all the insurances listed below, however insurance is an agreement between you and your insurance carrier. It may not cover all services in full. Please find out beforehand if you are responsible for a co-pay, co- insurance, deductable or if you require referrals from your Primary Care Physcian (PCP) in order to see Specialists. In these cases you will be responsible for the portion of the bill insurance did not cover.

  • Aetna
  • Anthem
  • BeechStreet
  • Blue Cross Blue Shield
  • Cigna
  • First Health
  • Great West
  • HealthNet
  • HIP
  • Humana
  • Medicare
  • Multiplan
  • One Health Plan
  • Oxford
  • Performax
  • PHCS
  • Union
  • United Health Care

Billing & Payments

We request payment at the time of office visit. We also request prompt payment on any bills you receive from our office. Personal checks, cash and all major credit cards are accepted as payment.




Under HIPAA law we are required to provide all our patients with information about their rights as a patient. The following form provides such information:


Patient Information

Appointments

Our office is located in the center of Lower Manhattan’s Financial District and Stock Exchange. We are always aware of how busy this area is and how important it is for patients to get back to work on time. This is why we pride ourselves in seeing patients promptly and efficiently. We also try to fit in our patients on the same day they call or the next available appointment. We require 24-hour notice for cancellations. There is a $75 fee for no-shows and same day cancellations.

Telephone Calls

If you should have any questions regarding your skin condition treatment, test results, prescriptions or billing, please contact our office and we will be happy to answer all of your questions. Our 24- hour answering service is also available for your messages.

At-Home Care

Surgical Treatment and cosmetic procedures are performed in our office on an outpatient basis. We provide all our patients with post treatment instructions which explains what they need to know once they leave the office. The following is a list of our forms