Welcome Packet & Forms
You recently made a new patient appointment to see Dr. Lynam or one of our skin care providers. Please find below our “new patient” forms that you can print, fill them out, and bring them with you on the day of your appointment.
The forms include our patient information sheet, History and Physical form, along with our HIPPA privacy notice.
You will need to bring the following:
- Drivers License or Photo ID
- Insurance Card
- Referral, if necessary
- If the patient is a child their Social Security number is required.
Richmond Surgical Arts, Inc. also requires that all fees be paid at the time of your visit. We accept cash, check, Visa, MasterCard, American Express and Discover. Directions to our office can be found at the bottom of this page. If we can be of any further assistance, please do not hesitate to contact our office at (804) 560-5260.
We look forward to meeting you!
* IF YOUR APPOINTMENT IS FOR A COSMETIC PROCEDURE, NO INSURANCE CARD WILL APPLY. COSMETIC CONSULTATION APPOINTMENTS ARE TYPICALLY ONE HOUR AND COMPLIMENTARY, HOWEVER A CREDIT CARD IS REQUIRED TO HOLD THE APPOINTMENT. IF YOU UNABLE TO KEEP THE APPOINTMENT, A 24-HOUR NOTICE IS REQUIRED TO AVOID A FEE OF $75.
* IF YOUR APPOINTMENT IS FOR A LESION REMOVAL, REMEMBER, YOUR FIRST VISIT WILL BE A CONSULTATION ONLY. YOU WILL THEN BE SCHEDULED FOR THE ACTUAL REMOVAL ON YOUR SECOND VISIT.