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New Patients

Hudson Dermatology and Neera Agarwal-Antal, MD, FAAD welcome new patients. Please call to schedule your first appointment at (330) 650-4200 or use the chat feature at the bottom of our website.

Be sure to bring your insurance card and photo I.D. to your first appointment.

We accept all major health plans. Please call the office at (330) 650-4200 for up-to-date information.

Update Your Patient Information

Please download the form below to update your patient information.

Please complete the form in its entirety. You may bring a signed copy to our office or fax us a signed copy.

Patient Registration Form

Office Policies

In order to provide the best service to all of our patients, we abide by the following office policies:
  • If you are under 18 years of age and will not be accompanied by your parent or legal guardian (this includes relatives, grandparents, aunts, uncles, or adult siblings), you will need a notarized written authorization.
  • If you are late for your appointment or are detained due to referral or insurance issues, you may be asked to reschedule. Those patients who are not seen at their scheduled appointment time due to referral or insurance issues may, if possible, be placed in the next rotation.
  • We call patients back to the exam rooms based on their scheduled appointment time, not their time of arrival.
  • Although it is our goal to run on time, it is not always possible. If you can no longer wait to be seen, please stop at the front desk so that we may reschedule you at another time. We are truly sorry for any inconvenience that this may cause you. Please take a moment to read the article “Waiting for Good Docs” by F. William Danby, MD (link opens as a PDF).
  • If you are not the patient scheduled for today’s appointment, we regret to inform you that for medical, legal, and ethical reasons, we cannot provide you with any medical advice. If you would like to schedule an appointment to be seen, please stop at the front desk to schedule. This protects the patient as well as the doctor.
  • If you require a school/work release for your appointment, please notify the staff before you leave the exam room. School and/or work releases will not be altered once issued. Time off will be determined by the doctor at the time of the visit.
  • If you require a 90-day supply of medication (for mail-in), please notify the staff at each visit. Keep in mind that some medications are not available in 90-day supply per doctor’s orders. Also, some medications may last 90 days as written and will not be written for more.
  • Neera Agarwal-Antal, MD, FAAD prides herself on providing the best treatment and care for her patients. She will prescribe the medication that she deems most appropriate to treat your condition. If cost is an issue for you, or your insurance company requires that you get generic medication, please make this known at each visit.
  • If you would like to request a copy of your medical records, you must fill out a HIPAA form so our office can provide you with your records. This form must be filled out in its entirety and signed by the patient or legal guardian. According to HIPAA guidelines, our office has at least 30 days to respond to your request, so you may not receive your copy immediately. Also, according to Ohio State Law, there will be a $3.51 charge per page for the first 10 pages, then $0.75 for pages 11–50, then $0.29 for 51 and up, subject to change. This applies to all medical records for any reason.
  • Refills: If a refill is requested outside of your appointment or on an emergency basis, there will be a $25 charge per prescription.
  • If you are a parent accompanying a minor who may come to future visits without you, please notify the staff that you would like to sign a Minor Consent Form so that we may treat the minor in our absence.
  • If you are a patient who is soon to be 18 years old and your parents will continue to be involved with your care, please notify the front desk so that we can fill out a New Patient Information sheet giving the office permission to talk to your parents, or request that the office not talk you to your parents about your care.

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