To All our New and Existing Patients
We are pleased to announce our adoption of an Electronic Health Record system. We need your help in making this a smooth transition.
Before your appointment, please complete or update your Medical and Dermatologic History information. This will expedite your visit and save you time when you’re in our office.
Before you enter our Electronic Record portal, please review the instructions for using the portal. This will take you through each section of the Portal, step by step, enabling you to successfully fill out, and then save, the information you have entered.
Next, after you have read this information, access our electronic record system, through the PATIENT PORTAL, using the user name and password we have given you, and reset your password.
Please complete all the information requested in each purple tab on the left side of the page: your medical, skin, medication, allergy history, pharmacy, etc. Be sure to be through, and check the option NONE for each section that is not applicable to you. Click “Save and Continue” after you complete each and every section.
The Firefox browser works best if using a computer with this electronic record system. If you have no already done so, you may download FireFox here or you can use your iPad.
IF you prefer to not use our Patient Portal, please download and complete our Medical & Dermatologic History form.
Other New Patient Forms
New patients, be sure to also download and complete these 3 additional forms, and fax or bring them into our office. Please DO NOT EMAIL any forms form to us as they will contain your confidential personal information and not be encrypted.
- Patient Information
- Medicare Patient Registration
- Notice of Receipt of Privacy Practices
- Insurance Policy
- Government Mandated Questionnaire for All Patients
Please bring with you the bottles of all your prescriptions so we can review their instructions.
Please plan to arrive 15 minutes before your appointment time, with your valid 2015 insurance card, and be prepared to pay any co-pay or deductible dictated by your insurance plan.
We kindly request at least a 24 hour advanced notice if you must cancel or reschedule your appointment.
— Jeffrey H. Binstock, M.D. and Associates
Office: 415 956-8686
Fax: 415 956 2853
Office: 415 383-5475
Fax: 415 383-1275