Due to the recent alarming increase in covid-19 infection rates,we are only scheduling in-office visits for procedures. All new patients and established patient follow-up appointments will be conducted virtually via teledermatology until further notice. Currently scheduled patients have been contacted and e-mail blast messages have been sent. We are also experiencing an extremely high volume of calls. Please be patient as we are also affected by the shortage in healthcare staff. Thank you in advance for your patience, understanding, and support.

Patient Registration Forms

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

History and Intake Form

Patient Registration

Financial Policy

HIPPA

Please give us a call at 301-273-1251 with any questions.

Providing Patients With An Exceptional Experience

What Sets Us Apart
  • Treatment From a Board-Certified Dermatologist & Cosmetic Surgeon
  • Our Team’s Personal Touch & Individualized Attention
  • Expertise in All Skin Types & Colors
  • A Skin Care Regimen Customized to Your Needs

Get In Touch

Schedule A Consultation
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What Our Patients Are Saying

Patient Reviews
  • “Dr. Surin is the nicest person ever. She’s friendly, welcoming, and down to earth. She’s really knowledgeable in her field.”

    - Lanae B.
  • “More than a doctor!”

    - Terri T.
  • “She is very knowledgeable, experienced and spends quality time w/her patients to get a full understanding of your condition and the necessary steps/procedures required for the treatment ...I left the office feeling very confident & pleased!”

    - Lisa W.