Skin & Dermatology Assessment Form
Asks about fitzpatrick skin phototype, chief dermatologic complaint, and lesion location. Built for full-body skin cancer screening examinations with ABCDE criteria documentation.
- Questions
- 12
- Pages
- 2
- Time
- about 3 min
Includes
- E-signature
- File upload
Your practice
Skin & Dermatology Assessment Form
Page 1 of 2 · Your information
Live preview. Tap through it like a patient.
Who it is for
- Full-body skin cancer screening examinations with ABCDE criteria documentation
- Chronic dermatologic condition monitoring using PASI, SCORAD, or BSA severity scales
- Teledermatology consultation referrals with standardized lesion photography and morphology descriptions
- Pre-biopsy lesion characterization and dermoscopic finding documentation
What's inside
Before you publish: Clinical review required: this worksheet does not calculate scores, diagnose, or recommend treatment. Confirm the questions and response options against your approved assessment protocol before use.
Page 1 · Your information
- Full NameText · Required
- Fitzpatrick Skin PhototypeLong Text
- Chief Dermatologic ComplaintLong Text
- Lesion LocationLong Text
- Lesion MorphologyLong Text
Page 2 · Additional details
- Lesion DimensionsText
- Dermatologic HistoryLong Text
- Dermoscopic FindingsLong Text
- Clinical Photo UploadPhoto Upload
- Assessment & Treatment PlanLong Text
From form to a ready patient

01
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02
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03
Your team sees who is ready
Each visit shows as ready once its forms are in. Answers land on the patient record.
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Questions
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