428 S. Durbin Suite #103
Casper, WY 82601

(307) 265-2936
(307) 265-6575 | Fax

New Patients

J.V.D. - Dermatology

H.O. - Hormone Therapy

Patient Paperwork Forms for Dermatological or Cosmetic Care

New BHRT Patient Forms

This form is to expedite your first visit as a dermatology or cosmetic patient.

If you are seeing us for Health Optimization LLC Hormone Treatment Therapy, please fill out and print one of the following:

Dermatology New Patient Paperwork Female Hormone Replacement Patient Form
Cosmetic Initial Consultation Paperwork Male Hormone Replacement Patient Form
Our fax number is 307-265-6575 or you may email the completed form to [email protected]

Records Release Forms

Are you choosing to be seen at JVD.HO and moving from another office? You will need to complete the form in the link below.

Records to be sent to JVD.HO

Are you leaving JVD.HO and choosing to be seen elsewhere? You will need to complete the form in the link below.

Records from JVD.HO to be sent to another practice.

Once completed, either fax or email the form so your records can be released.

Our fax number is 307-265-6575 or you may email the completed form to [email protected]

In order to view, edit and print these forms, you will need Adobe Acrobat Reader installed.

Click here to download it.

Are you visiting us for the first time?

Your first visit to Jordan Valley Dermatology involves a few special steps so that we can get to know you. However, we want you to understand what to expect from your first visit to our clinic. We want you to know that we are pleased to treat our neighbors with excellent dermatological care.

Throughout the site you'll find all the practical information you need, such as a street view of our office, practice hours, and more. Perhaps you will want to spend some time getting to know our committed staff . Save some time and learn about our payment policies by completing and printing out the patient forms in advance of your appointment. Please remember to bring your insurance card(s) and drivers licence for your appointment.

Interested in upcoming events and special news?

Click here to sign up for our email list.

Map and Directions

Hours of Operation







Monday: 9:00 AM - 4:30 PM Monday: 9:00 AM - 5:00 PM Monday: Call to Schedule
Tuesday: Closed Tuesday: 9:00 AM - 5:00 PM Tuesday: Call to Schedule
Wednesday: Closed Wednesday: 9:00 AM - 5:00 PM Wednesday: Call to Schedule
Thursday: 9:00 AM - 4:30 PM Thursday: 9:00 AM - 5:00 PM Thursday: Call to Schedule
Friday: 9:00 AM - Noon Friday: 9:00 AM - Noon Friday: Call to Schedule
Saturday: Closed Saturday: Closed Saturday: Closed
Sunday: Closed Sunday: Closed Sunday: Closed

What To Expect

Being well-prepared for your appointment will ensure that our providers have all of the needed information to provide the best possible care for you. It will also help alleviate any unnecessary anxiety you may be feeling prior to your first appointment. Educate yourself on your symptoms by reviewing the content on this site. Take advantage of our Patient Education panel which you will find at the right of this screen. We look forward to your first visit!

Mission Statement

Our practice is working together to realize a shared vision of uncompromising excellence in dermatology.

To fulfill this mission, we are committed to:

  • Listening to those we are privileged to serve.
  • Earn the trist and respect of patients, profession and community.
  • Exceed your expectations.
  • Ensure a reative, challenging and compassionate professional environment.
  • Strive for continuous improvement at all levels.