DermHelpCentral

Established Patient Virtual Visit

In an attempt to reduce your exposure to and the spread of COVID-19 we are trying to limit the number of patients seen in our office and insure safe-distancing. At the same time, we recognize the need to evaluate all patients seeking an opinion regarding a skin problem.

If you call our office, we can email you the appropriate forms for new and established patients. You can either email these back to us or send us a synopsis. Photographs will be helpful and be assured that our privacy will be respected. Ideally, photos should be taken under natural daylight.

Established Patient Form.

You can fill this out or just give me the information in narrative form.

Your name:

Your age and occupation:

A brief description of the skin problem. Please send us photos, if appropriate. Let us know how long you’ve had this problem, whether it has been treated by another physician, and with what medications.

General Information:

• Please tell me how you are doing.
• Do you need a refill of your medication? If so what is it and what dose are you taking.
• What specific questions do you have?
• Anything else I should know?

How are you doing with the stress these days?

Please let me know if you have any other specific concerns.

You can email the answers to me at [email protected] and [email protected] or fax them to my office at 413–458–4224.

We could also use FaceTime.

Thank you

New Patient Form for Virtual Visit

In an attempt to reduce your exposure to, and the spread of, COVID-19 we are trying to limit the number of patients seen in our office and insure safe personal distancing. At the same time, we recognize the need to evaluate all patients seeking an opinion regarding a skin problem.

You can either email this back to us or send us a synopsis. Photographs will be helpful and be assured that our privacy will be respected. Ideally, photos should be taken under natural daylight.

Your name:

Your age and occupation:

A brief description of the skin problem. Please send us photos, if appropriate. Let us know how long you’ve had this problem, whether it has been treated by another physician, and with what medications.

General Information: In a paragraph or two, let me know:

• What other skin problems you may have had, whether any skin problems runs in your family, what allergies do you have, specifically to drugs and what the reaction was.
• Please let me know what other problems you have been treated for by physicians or other health care providers.
• Please let me know all medications you are taking. This includes pills, liquids, injectable medications, over-the-counter medications. Include all creams and other topical medications.
• Please let me know any other concerns you may have.

Do you have a personal or family history of asthma, hay fever, eczema, or hives?

Do you have a personal history of skin cancer? If yes, what type.

Do you have a family history of skin cancer and if so what type?

Are there any particular stressors in your life that we should know about?

For Women Only. Are you pregnant or breast-feeding?

If it’s appropriate, please let me know if you are using birth control pills or hormones.

In a brief paragraph let me know if you have any other specific concerns and what comments you would like to make.

It is said: "If the physician listens long enough, the patient will tell her/him what the diagnosis is.”

Ideally, you can email the answers to me at:

Dr. Eloern’s personal email: [email protected]        

Office email: [email protected]

Office Fax: 413–458–4224.

Thank you!

Virtual Patient Visits

In an attempt to reduce your exposure to, and the community spread of, COVID-19 we are trying to limit the number of patients seen in our office. This insure safe social distancing. At the same time, we recognize the need to evaluate all patients seeking an opinion about, or needing a follow-up for, a skin problem.

To this end, we have created four Patient Encounter Forms.  There may be more and these will need to be fine-tuned.

 

1. New Patient Form
   Download New-dermatology-patient-form NEW
2. Established Patient Form
   Download David J Elpern Established Patient Form
3. Accutane Patient Woman.
   Download David J Elpern Isotretinoin Patient Form for Women
4. Accutane Patient Man
   Download David J Elpern Isotretinoin Patient Form for Men

If you have questions about how to take a picture of your skin problem, here is a link to a guide.  This will be TMI (too much information) for most of you.  The basic rule is take two to three pictures from different distances or angles and take them during daylight, when possible, and not indirect sunlight.

 

You can contact us at:

David Elpern 

Our Office

Office Telephone Number:  413-458-2800

Office Fax: 413-458-4224