In an effort to save you time and to save our environment you may now fill out all of your paperwork online.  You will need a secure pass code to access our system. 

General forms

Please email the office info@haleyderm.com to receive your secure password that will enable you to login. Then you will be able to set up your login screen name and the password of your choice.

Patient Login

If you have already made an appointment or are already our patient, click here to FILL OUT or UPDATE your PATIENT FORMS.

Cosmetic consents and instructions

• Silk Peel Consent Form
• Chemical Peel Consent Form
• Laser Hair Removal Instructions
• Laser Hair Removal Consent Form
• Photorejuvination Consent Form
• Photorejuvination Treatment Instruction
• Accent XL Medical History
• Harmony Pixel Consent Form
• Post Treatment Care for Accent
• Post Treatment Care for Pixel
• Privacy Policy

These forms require Adobe Acrobat Reader.
Click the Adobe logo to download.