Schedule an Appointment – Dermatology Group of the Carolinas

Appointment Request Form

Thank you for your interest in a visit at the Dermatology Group of the Carolinas. We look forward to taking care of you. Please call us at 704-784-5901 for an appointment or fill out the form below.

To ensure your protection during the visit, we have implemented strict safety protocols. Click here to read about our COVID-19 Policies. If you prefer to be seen via telemedicine, please contact our office.

Currently we are experiencing a higher volume of on-line appointment request. Please allow 48-72 to process. If you need more immediate attention please call the office at 704-784-5901. Thank you.

First and Last Name

Phone Number

Email Address

Date of Birth

Are you a new patient to our practice?

Yes

Please indicate preferred location for your visit

Concord Office

Huntersville Office

Salisbury Office

What day of the week do you prefer your appointment?

Please indicate your preference for the provider you would like to see.

Please indicate the reason for your visit

What is your preferred call back time?

8 AM - 10 AM

10 AM - 12 PM

12 PM - 2 PM

2 PM - 4 PM (Monday - Thursday Only)