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Mohs Micrographic Surgery Forms

Dr. Adam Stibich, Dr. Dow Stough and Dr. Martin Johnson require the following paperwork to be completed the morning of your Mohs procedure.

Please click to download, then complete your paperwork and bring it with you to your visit:

  • Consent – Surgical Excision
  • Mohs Surgery Preop
  • Medication List
  • Having Skin Cancer Surgery
  • Mohs Brochure
  • Excision of Skin Lesions
  • BCC & SCC Handout

The Dermatology Clinic

3633 Central Ave., Ste. N
Hot Springs, AR  71913
501.623.6100

Hours

Monday through Friday
8 a.m. – 5 p.m.

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