This form should not be used to relay medical information.  It is provided to send NON-MEDICAL QUESTIONS ONLY. Instead all medical questions and information should be submitted when you REGISTER and send your case using DermUtopia’s HIPAA compliant platform.

Phone: (703) 229-2544

Fax: (209) 759-4655

Participating Insurances

  • Medicare
  • BlueCross BlueShield

Billing questions contact Shelley Reinoehl

  • Phone (888) 775-0200
  • Fax (443) 262-9725

Additional patient forms

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