Refer A Patient

Thank You For Your Referral

Thank You For Your Referral

Humboldt Derm is pleased to provide the highest quality modern dermatologic care to your patients. To refer a patient to our care, please download and complete the Dermatology Referral Form then fax it to (707) 444-1369.

For your convenience, Humboldt Derm's New Patient Information Package is available to you. Please provide these documents to the patient so that he or she may complete them prior to the appointment.

Patient Information Package Patient Information Package (180 KB)

Physician Referral Form Physician Referral Form (53 KB)

Thank you again for your referral. Humboldt Derm is completely dedicated to achieving ideal outcomes for our patients.