Washington DC Dermatologist
Schedule an Appointment Today 301.273.1251
A Dermatologist Focused On Your Patient Experience

Patient Registration Forms


All forms must be printed and brought with you to your appointment. We will not print any forms.

Registration forms may be accessed by clicking the below image or by following this link: Visage Dermatology Patient Registration Forms

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Please give us a call at 301.273.1251 with any questions.

What Our Patients

Are Actually Saying
  • “Professional and family like environment”

    Floyd E. F. Jr

  • “What a wonderful experience”

    Barbara H.

  • “Kind, compassionate, exceedingly knowledgeable, thorough, professional efficient.”

    Darnell R.

  • “The best Dermatologist in town”

    Evelyn A.

  • “I can’t wait to go back!!!”

    Ednese H.

  • “Dr. St. Surin-Lord was absolutely wonderful.”

    Satisfied Patient

  • “Excellent Dermatologic Services”

    Kisha Jennings

  • “I was so happy with my results”

    M. M.

  • “She’s made me feel comfortable and knows what she is talking about”

    Satisfied Patient

  • “She is great and her staff is so personable and professional. Very refreshing!”

    Cynthia W.

  • “I can honestly say I felt I’d been a patient for years.”

    Tamika L.

  • “Makes me feel like family”

    T. G.