Welcome to San Luis Dermatology & Laser Clinic

The San Luis Dermatology and Laser Clinic has been serving the San Luis Obispo area in the person of Dr. Jeffrey Herten since October, 1977. From a one doctor, one nurse, one front office person practice in an 800 square foot office, the clinic has grown into a three physician, and eleven support staff practice in a state-of-the-art 3900 square foot facility.

 

 

New Patients

 

 Dr. Michael Heffernan, M.D. and Craig Wiggins, FNP-C are currently accepting New Patients. Please call the office directly to schedule your New Patient appoinmtment (805) 541-2650. 

       

You can download and print our New Patient Forms by clicking on the blue links below.

Please make sure to bring your Insurance cards, Photo ID, and legible list of Medications to include dosage to all appointments.

 

Thank you. 


General New Patient forms:           

1.  Patient Information 3-10-17.pdf

2.  Health History Intake Form 3-10-17.pdf

HIPAA Auth to release PHI.pdf   2.22222222.2222

3.  HIPAA Release Form.pdf

           

All patients please review Office Payment and Cancellation Policy below.

Thank you.

     Authorization of Pymt Policy.pdf

     Cancellation No Show Policy 06-16-14(2).pdf

 

 Miscellanous Forms:

    Authorization to treat a Minor.pdf

    Credit Card Authorization Form.pdf

    Authorization to Release Medical Records to Outside Doctor.pdf

    Release Medical Records to Patient.pdf