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Unique Dermatology and Spa
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New Patient & New Returning Patient Registration

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If you have not had an appointment in more than 2 years you are considered a new returning patient.
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  • Pharmacy Information

  • Employer Information

  • Emergency Contact Information

  • Insurance Information

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  • Secondary Insurance Information

    Please Note: We will file your claim with your Secondary Insurance company, but you are responsible for paying the secondary amount. However, you will get a refund once the secondary insurance company pays.
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  • Medical History

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  • You will be contacted within 48 hours to confirm your exact appointment time & day.
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Unique Dermatology

2525 W Bellfort Ave #105-A, Houston, TX 77054
(713) 741-3376
info@mooreunique.com

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