About Telederm Service
Simple and Convenient
Telederm gives us the ability to provide quality healthcare services safely and remotely to patients via computer, tablet or mobile device. Make the most of your time and meet your Medical or Cosmetic Provider online. It’s simple and convenient. See your Provider from anywhere, just click their personalized room link (which we’ll provide) to join them for a video call. Virtual consultations and visits will be billed accordingly.
All data is encrypted, your sessions are anonymous, and none of your information is stored. We adhere to all HIPAA data privacy requirements.
Find out if Telederm is right for you
Please call us at 520.795.7729 (Monday – Friday, 8:00 AM – 5:00 PM) to see if you’re a candidate for this service. Note: Not all patient visits can be performed via Telederm as they may require in-person evaluation and care.
SCHEDULED TELEDERM VISIT
FORMS & INFORMATION FOR YOUR TELEDERM VISIT
1. NEW PATIENTS: Please print, fill out, and mail (or email) the New Patient Forms prior to your Telederm visit with us. Please download the forms below.
2. You may EMAIL these forms to: email@example.com.
3. You may MAIL these forms to: PIMA DERMATOLOGY / 515O E. Glenn St. / Tucson, AZ 85712. Please allow up to 7 business days for the mail to reach our office.
4. RETURNING PATIENTS: You may also use these forms to update your information.
5. For a list of insurances accepted, click here.
NEW PATIENT FORMS
Telederm Consent Form
HIPAA / Advance Directive
If the patient is under 18 years of age, please download and complete this form:
Consent for Treatment of Minor
POLICIES AND PAYMENT INFORMATION
Please review our Policies and Payment information here.