Esti G. Gumpertz, M.D.     Atrium Dermatology®

Dermatology and Dermatologic Surgery

Hilcrest Medical Building #2

6801 Mayfield Road, Suite 244, Mayfield Heights, Ohio 44124

Telephone (440) 646-1600

Fax: 440-646-1505   email: AtriumDerm@aol.com


Confidential Information Form 

 

Few things are more frustrating than filling out forms in doctors' offices. Often one forgets to give the doctor important details, or one feels uncomfortable filling out the details while sitting in the waiting room.  To make things easier, we have made all our forms available for download.  Simply click here to print out the forms.  Complete them in your own time, and hand them to us when you arrive at our office. 

 

Remember:  the information you provide us helps us help you!

 

 

 

Atrium Dermatology® Expert skin care you can trust 

 

 

Don't forget to bring your primary and secondary insurance cards, personal photo I.D. and co-pay with you when you come in.

We look forward to helping you with all your skin care needs.

Call us at (440) 646-1600 or email us at AtriumDerm@aol.com with any questions

 

The folowing article, taken from Wikipedia may prove useful in helping you prepare for your visit to our office
How to Describe Medical Symptoms to Your Doctor


Visiting the doctor for a new, undiagnosed medical problem can be daunting. Patients often struggle to try to get their symptoms across to the doctor in an effective manner, and the physician needs to gather information needed from a patient without overlooking anything important. All this must be done during a relatively brief medical interview. Here's how you can maximize the appointment by giving the doctor the information looked for in the same format learned in medical school.

Steps   

   1. Bring an up-to-date cumulative patient profile with you to the interview. You can create one by summarizing your medical history on a page. Include dates of, and reasons for hospitalizations and surgery. You may not end up needing to refer to it, but if questions about your medical history come up, having one will maximize the time you can spend discussing your current medical issue(s). Bring your current medication bottles, which list the name & dose information, including herbal supplements if applicable.

   2. Describe your basic reasons for the visit in one or two sentences. Most doctors will start with the interview with something like, "What brings you here today?". Preparing an answer to this question in advance will facilitate the visit. Some common symptoms include pain, weakness, nausea, vomiting, diarrhea, constipation, fever, confusion, breathing problems, or headache.

   3. Recall the onset and timing of your symptoms. Include starts, stops and frequency. ("I get bad pain right in between my menstrual periods that lasts about three days.") Be prepared with dates and times, if possible. ("The first time I remember feeling this way was on the 15th. It tends to get worse in the late evenings, but occasionally I feel it in the early mornings, too.")

   4. Explain what makes the pain better or worse. Make note of any movement that sharpens the pain ("My finger feels fine unless I bend it towards my palm, and then I feel a sharp pain.") or lessens it ("It seems to go away when I lie down on my side."). If any food, drinks, positions, activities, or medications worsen or alleviate the symptoms, make it clear. ("The fever got better with Tylenol but then came back in two hours.")

   5. Use adjectives to describe your symptoms more fully. Not all pain is the same. It can be sharp, dull, right on the surface of the body, deep inside, etc. Example: "When I get dizzy, it isn't just that I feel like I'm going to faint; it feels more like the world is constantly spinning to the left!". Without getting overly poetic, try to point out what makes this sensation different than other types of pain you have felt before.

   6. Point to the location of your symptoms. Include details if the pain moves about. ("The pain was right around my bellybutton but now, it seems to have moved over here near my right hip.")

   7. Rate the severity of your symptoms. Use a scale of one to ten, with one being almost nothing and ten being the worst possible symptom you can imagine. Be honest, and don't minimize or exaggerate. "Ten out of ten" pain (in the eyes of medical professionals) would render a person almost incapable of speech or any other act such as eating or reading. ("I was sitting eating lunch and then I suddenly got the worst headache of my life out of nowhere. It was so bad that it nearly knocked me unconscious. Definitely a nine or ten.")

   8. Describe the setting and your condition when the symptoms occurred. Where were you? What were you doing? How different was the setting and activity than what you normally do? What had you been doing right before the symptoms arose, and earlier that day?

   9. List other things that happen at the same time as your symptoms. ("During the three weeks I've been having these fainting spells, my wife also said that I've been looking very pale and I've also had these dark colored bowel movements and I've lost ten pounds even though I'm eating exactly the same.")

  10. Expect the doctor to examine you and potentially order some tests or a trial of treatment.


Tips   

    * Know your own health. It is very frustrating for both the patient and the doctor to meet face-to-face and then begin piecing together the story.

    * Bring written notes about what you want to ask. Many people when faced with a doctor go blank! A pen to write down what the doctor says is handy, too. Many patients often remember things they want to ask the physician after the visit has concluded and are then embarrassed to call back about it.

    * Consider bringing a friend or family member for the visit if you are not sure how to explain your physical problem correctly, if you are forgetful or fluster easily.

    * Honesty is key. Physicians are bound by a duty of confidentiality. If your continued health is at stake, you may as well tell them every detail.

    * Make a list of questions you have for your doctor. Most of the time, due to time constrains, you will forget what you were supposed to ask!

    * Think about the symptoms and their nature before you get to the doctor to save both your own and the doctor’s time as well as making it diagnostically clearer to the doctor.
 

 

Atrium Dermatology® Expert skin care you can trust

We proudly service Cuyahoga, Lake and Geauga counties.

Call us at (440) 646-1600

or send us an email at AtriumDerm@aol.com

For a map and directions, click here.


Among dermatologic conditions diagnosed and treated in our office are: Acne, Actinic Keratoses, Allergic Skin Conditions, Alopecia, Alopecia Areata, Athlete's Foot (Tinea Pedis), Atopic Dermatitis, Baldness, Basal Cell Carcinoma, Broken blood vessels, Complexion problems, Contact Dermatitis, Cysts, Dermatoses, Diseases of the nails, Ear lobe repair, Eczema, Folliculitis, Freckles, Genital Herpes, Herpes Simplex, Herpes Zoster (Shingles), Hair loss, Hair thinning, Hives, Insect bites, Jock Itch (Tinea Cruris), Lichen Planus, Lichen Simplex,  Liver Spots, Moles, Melasma, Melanoma, Molluscum Contagiosum , Rosacea, Scabies, Skin lesions, Spider Veins, Spots, Systemic Lupus Erythematosis, Poison Ivy, Oak and Sumac, Psoriasis, Ringworm (Tinea), Skin Cancer, Squamous Cell Carcinoma, Tinea Versacolor, Tinea Capitis,  Tinea Corporis, Toenail Fungus (Onychomycosis), Urticaria Pigmentosa, Varicose Veins, Vitiligo, and Warts. We are proud to service patients from all around the Cleveland metropolitan area, including Aurora Avon Avon Lake Beachwood, Bedford Heights Brecksville Brook Park Brooklyn Chagrin Falls Cleveland Cleveland Heights Eastlake Euclid Fairview Park Independence Kent Lakewood Lyndhurst Macedonia Mayfield Heights Medina Mentor North Olmsted North Royalton Ohio Painesville Parma Pepper Pike Richmond Heights Rocky River Seven Hills Shaker Heights Solon South Euclid Stow Strongsville Twinsburg University Heights Warrensville Height