The Lloyd Dermatology and Laser Center
8060 Market Street, Youngstown, OH 44512
(330) 758-9189

Preparing for Your Visit to the Lloyd Dermatology Center

Before your first visit

If you are a first-time patient, you can speed your visit by downloading, printing, and filling out the following paperwork ahead of time.

All new patients should complete and these forms for their first visit:
Financial Policy Form (pdf)
New Patient Medical History Form (pdf)

Please fill out and bring ONE of these forms, depending upon your insurance:
New Patient Registration Form (pdf)
New Patient Medicare Form (pdf)

This is for your information only. You do not need to bring this form with you:
Privacy Policy (pdf)

We accept the following forms of insurance

  Traditional SuperMed Classic® SuperMed Professional™ SuperMed Plus® SuperMed Select® SuperMed HMO® SuperMed Preferred Advantage Plan

  Blue PrioritySM Blue Preferred® Primary (HMO) Blue Preferred® Primary Plus (POS) Blue Access®(PPO) Blue Traditional® Lumenos Health Savings Account Anthem Senior Advantage

Medicare & Railroad Medicare

Palmetto GBA Medicare Aetna Medicare CGS Medicare Humana Medicare

** For other insurances not listed above, we will copy your insurance card and submit the claim as a courtesy, but you will be responsible at the time of service for payment of services rendered.
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