710 Military Cutoff Rd. Suite 320, Wilmington, NC 28405

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Patient Documents

We value you your time as much as we value your skin, please review the following information so we can focus our time on your skin care needs.

Before your visit – new patients

Please call to schedule an appointment and provide your health insurance information for verification. After you have called, access and submit the Online Patient History Form prior to your visit to expedite your time in our office.

If you would prefer not to fill out the online form, you can download the Patient History Form and print and bring this to your appointment or scan and send.

Patient privacy policies can be accessed here:

Note: Please review the notice prior to your appointment. Notice of Privacy Practices is for review only and does not require printing or submission.

established patients

If you were web-enabled during your initial visit, you will have access to your own personal Patient Portal which stores prior visit information, patient education, and allows you to make changes to your personal information in our system. Access information would have been sent to you at your original visit. If you need assistance in gaining access to the portal, please contact our staff.

we currently support the following insurance plans:

Blue Cross Blue Shield (except BCBS Value Plans)
Tricare Standard & Prime

Important Insurance Notice:

  • For insurances we are out of network and not contracted, we do offer self-pay pricing. Please inquire with our office.
  • As a policy we will not provide any coding information for you to submit claims to your insurance if we are out of network.
  • We no longer accept United Healthcare or any insurance administered by UHC as of 8/23/21. Please note this includes any Medicare Advantage plans administered by United Healthcare. We can accept Medicare supplements (secondary plans) to Medicare that are administered by UHC such as AARP.
  • We unable to see Medicaid patients as we are out of network and unable to submit prescription requests.

your visit

Directions to our office can be found on the Contact page of this website.

Patients who are scheduled for a problem focused dermatology issue unrelated to skin cancer will have an exam focused on that specific condition. Should you or your provider ultimately request a comprehensive skin cancer screening, this may need to be scheduled at a separate visit.

Please bring your pharmacy information with you. In order to decrease errors and save paper we have adopted an electronic prescribing system.

Note: Minors under the age of 18 must be accompanied by an adult for their first visit. After your first visit with your child, you will be provided with an optional consent form found here that will allow you to authorize future visits and or treatments in your absence.

financial information

Your insurance coverage is an agreement between you and your insurance company. Financial responsibility rests with the patient for deductibles, co-insurances and non-covered services. Insurance coverage is a variable and we cannot guarantee what services will be covered by your particular plan. If you have an HMO type of insurance plan, then you will need to get a referral from your family doctor or primary care provider. It is your responsibility to know the requirements of your insurance program. We will ask you to sign an authorization form requesting that insurance payments be sent directly to our office when appropriate.

Co-Payments are due at time of service. For your convenience we accept personal checks, Visa, MasterCard, Amex, Discover card and cash.

A no-show fee of $50.00 will be charged to dermatology related patients who fail to show for their appointment and who give less than 24 hours notice of cancellation. For aesthetics patients, your credit card will be requested to guarantee your appointment. If an aesthetics client does not show up for their appointment and does not provide notice of a cancellation prior to their appointment, they will be charged for 50% of the planned services on the card used during the reservation process.

pathology, labs and x-rays

Surgical specimens are sent to a lab to be analyzed. The fee for this is a separate charge from the office visit and may be billed directly by the processing lab. Results are usually available 7 to 10 days after the test has been performed. Questions regarding payments for laboratory services should be discussed with the lab.

prescription refills

Prescription refill requests will be taken only during regular office hours. Hours of operation are 8am-5pm (M-TH), 8am-12pm (F).

switching physicians? / patient records release

Do you need medical records from a prior physician sent to our office, or your records from WDC released? If so, fill out the Authorization for Use or Disclosure of Health Information form. We have developed this online form to expedite the process so you don’t have to print, scan, or physically send us your release in the mail. Upon completion, this form is sent to WDC to process and a copy of the completed release will be sent to your email for your records.

If you would prefer to print the ‘Authorization for Use or Disclosure form’ and sign, you can find the PDF link below. You will need to bring this with you to the office for our staff to process.

minors visiting the practice

In an effort to meet the rules and standards set forth by HIPAA and the NC Medical Board we require a signed consent from the parents or legal guardian of any minor (anyone < 18 yrs old) who may receive treatments for a diagnosis that is non-life threatening. This consent form is your way of authorizing WDC and it’s medical providers to evaluate your child in the case you cannot accompany them to their visit.

Aesthetic Clients: No-Show and Cancellation Policy and Fees

In an effort to improve the availability of our Aestheticians to our loyal clients, we have a no-show and cancellation policy in place. The policy is as follows: A client must cancel their appointment 1 day prior to their treatment to avoid a cancellation/no-show fee. Any client who notifies our staff during the day of the treatment or simply does not show up for their appointment will be charged 1/2 of the booked charges for their appointment. Any last minute cancellations out of your control should be communicated to our staff or your aesthetician for waiver consideration. No-show example: if you book a Facial for $150 and do not show up to your appointment, you will be billed for $75.

Cosmetic Appointment Deposit & No-Show Policy

We ask all clients to contact us at least 24hrs before your scheduled visit with any changes so our staff can reschedule you and accommodate others who are waiting to schedule.

For cosmetic patients with ‘Extended Visits’ scheduled (See a full list below), we require a ‘Cosmetic Appointment Deposit’ of $100 due to the high scheduling demand. Cosmetic Appointment Deposits can include any Star Credits that may be on file. Should you No-Show your visit or cancel within 24hrs, your $100 Cosmetic Appointment Deposit would be applied as a No-Show Fee.

For New Injectable patients for Dr. George, we do require a $100 deposit that would be credited toward your treatment.

For any patient who No-Shows multiple times for cosmetic treatments, WDC reserves the right to require that patient to pre-pay for any future treatments prior to scheduling.

WDC will request the full cost of the anticipated treatment to be paid prior to the visit. Should the patient no-show that visit, a 50% no-show fee will be deducted from that deposit amount.

Extended Cosmetic Visits List (treatments requiring a Cosmetic Appointment Deposit):

  • Ellacor
  • BBL
  • CoolPeel
  • Virtue Microneedling
  • Ulthera
  • CoolSculpting
  • CoolTone
  • Viveve
  • Miradry
  • Fraxel