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Welcome Packet & Forms

Welcome!

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 out, and bring with you on the day of your appointment.

The forms include our Patient Information Sheet, History and Physical form, and HIPPA privacy notice.

Please bring the following with you to your first appointment:

  • Driver’s 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 ARE 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.

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