Telemedicine Patient Forms

Providing us with an accurate, up-to-date medical history will allow our physicians to tailor your course of treatment. All you have to do it click on the link below, print the form, fill it out and bring it with you to your appointment OR edit the form and email to appointments@bellairedermatology.com.

Essential Telemedicine Services

Acne

 

Athelte's Foot

 

Cold Sores

 

Eczema

 

Hives

 

Melasma

 

Poison Ivy

 

Psoriasis

 

Rashes

 

Ringworm

 

Rosacea

 

Shingles

 

Skin Infection

 

Sunburn

 

New Painful or Spreading Rashes

 

New Blisters

 

New Onset of Severe Skin Pain

 

Cocern of Melanoma Skin Cancer

 

Post Skin Cancer Surgery Complication

 

Post Cosmetic Procedure Complication

Cosmetic Department Virtual Consultations 

may be scheduled for $75,

which will be applied toward 

product or service.

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Testimonials

"These guys hung the moon. They actually care! Dr. Teller takes his time & his team has an eye for precision, they work alongside him for a great result that is just perfect for me. I’ve been coming for so long for this very reason. I would just never not. They are very extensive. I can’t thank them enough!"

BELLAIRE DERMATOLOGY

© 2019 Bellaire Dermatology

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Get in Touch

6565 West Loop South, Suite 800
Bellaire, TX 77401

Medical: (713) 661-4383
Cosmetic: (832) 553-2314

Clinical Research: (832) 331-7070

CoolSculpting CoolTone: (281) 610 - 4195

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In order to protect Patients & Staff

Please remember to wear your mask to appointments & we ask that only parents or guardians accompany minors to help us stagger the number of people in office.