Physician Portal

Patient Information

For improved triage accuracy, submit a clear image of the concerning lesion through this secure portal which complies with HIPAA regulations. Additionally, send a referral form that mentions the attached photo via fax to our office.

Note that photos submitted without the corresponding referral form will not be considered for evaluation.

Referral (fax) form completed?
Drop files here or
Accepted file types: jpg, jpeg, pff, gif, Max. file size: 1 MB, Max. files: 3.
    Maximum 3 photos in any of the following formats will be accepted: jpg, jpeg, pff, gif. Maximum size per image 1MB.