Fractional Laser Treatments (FX)

(810) 220-4422

Contact us today to schedule a consultation

Patient Information Page

The below links allow our current and new patients to login to the system to update their information. 
If you have any questions, please call us at (810) 220-4422.

Existing Patient Login 
New Patient/User Login

Click on a link below to scroll down to the section you are looking for:

More patient information is provided below:

Registration Forms 
Billing Forms
Medical Forms
Additional Resource Links

Registration Forms
Our new patient forms are listed below.  Please print these forms and have them completely filled out prior to arriving for your appointment.  Please also remember to bring your driver’s license and all appropriate medical insurance cards so we can ensure that your visit will be billed properly.    

As a final reminder the policy here at Brighton Dermatology and Regenesis is to collect ALL co-pays and outstanding balances after each visit is completed, so please be prepared to settle your account responsibilities before leaving our office.  We accept Cash, Checks, and the following credit cards: Visa, MasterCard and Discover.

Please click here to download Registration Form #1 
 
Please click here to download Registration Form #2
 
Please click here to download Registration Form #3
 
Please click here to download Registration Form #4
  

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Billing Forms
Please find below the insurance plans accepted here at Brighton Dermatology and Regenesis.  Please note that some of the dermatological procedures we perform may be considered cosmetic which means that it is solely the patient's responsibility to cover the entire charge of the procedure.  Please contact your insurance company to inquire about your benefit level if you are unsure.  
Also please contact your insurance company to inquire about the need for a referral prior to scheduling your appointment.  The following insurances are accepted here at Brighton Dermatology and Regenesis.  Please click on the insurance and you will be redirected to their website, to help answer any questions that you may have.

Aetna (all policies are accepted - please note - you may need a referral based on the plan) 

Blue Cross / Blue Shield (all policies are accepted)

Blue Care Network (please note - this insurance may need a referral)

BCN Advantage (please note - this insurance may need a referral)

Beech Street

Champus / Tricare

Cigna  (all policies are accepted - please note - you may need a referral based on the plan) 

Cofinity (formally known as PPOM)

DMC Care

Health Alliance Plan (HAP)  (all policies are accepted - please note - you may need a referral based on the plan)
  
Health Plus PPO & HMO (please note - patients with the HMO plan may need a referral) 

PHCS

Priority Health

McLaren Health Plan (please note - only Dr. Cliffel participates with this insurance)

Medicare

Medicare Plus Blue

Medicare Humana

Medicare (HAP)  (please note - this insurance may need a referral)

Medicare Advantra Freedom

Medicare Railroad

Medicare Today's Option

United Health Care

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Medical Forms
If you need medical information sent to or from our office you can use the links below to download the necessary form to meet your needs.

Please fill out the appropriate form in its entirety, failure to do so will result in a delay for your request.

Please click here to download this form to transfer your records to Brighton Dermatology. 

Please click here to download this form to transfer your records from Brighton Dermatology to another facility. 

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Additional Resource Links
Here are the links that Brighton Dermatology recommends as an additional resource in regards to your healthy skin.

American Academy of Dermatology 

American Osteopathic College of Dermatology   

American Society For Dermatologic Surgery

Botox® Cosmetic Official Website

Juvéderm® Official Website

Lumenis® Aesthetic Ultrapulse FX Laser (used for facial resurfacing)

National Psoriasis Foundation®

National Rosacea Society

National Vitiligo Foundation, Inc.

RADIESSE® Official Website

Restylane® and Perlane® Official Website

Sculptra® Aesthetic Official Website

Skin Cancer Foundation

XTRAC® Excimer Laser (used for psoriasis treatments)

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