Download Patient Forms

Thank you for choosing New Jersey Dermatology & Aesthetics Center. Our team is committed to providing you and your family with the best dermatologic care and patient experience possible.

In order to facilitate your first appointment, please carefully print and complete the Patient Registration Form and bring the completed form to your first appointment with a list of all medications you are currently taking and your most current insurance card.

PATIENT REGISTRATION FORM

Existing Patient Portal
PATIENT PORTAL

Online Payments
PAY ONLINE

Telemedicine Instructions, Consents, and Forms
Telemedicine Guide
Insurance Signature on File
Informed Consent For Telemedicine Services
HIPAA Authorization and Consent
Convenient Pay Agreement
Consent to be Photographed
AUTHORIZATION FOR MEDICAL TREATMENT, ADMINISTRATION OF LOCAL ANESTHESIA AND THE PERFORMANCE OF MINOR SURGERY ANDOR PROCEDURES

 

“Dr. Husain is an amazing cosmetic surgeon. He has far exceeded my expectations each time I have had a procedure performed. Dr. Husain is warm, personable, and goes out of his way to answer questions, make suggestions and dispel any concerns I may have. He carefully explains each procedure and always thoroughly reviews the post-operative care. His artistic eye combined with exemplary surgical skills make for a perfect result every visit.”

– Clare Morison

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