
Patient Forms
Please print and fill out each one of the listed forms and bring it to your initial appointment.
New Patient Forms
HIPAA Forms
PHONE: 800.245.7154
Phone: 800.245.7154
4390 Fayetteville Road ~ Lumberton, NC 28358

Please print and fill out each one of the listed forms and bring it to your initial appointment.
PHONE: 800.245.7154
©2008 Southeastern Dermatology / Cosmetic Surgery Center
This site was created by Medical 101
Dr. Andrew A. Hendricks is a dermatologist providing procedures such as Botox, Restylane and
Microdermabrasion in Lumberton.
Dr. Andrew A. Hendricks is licensed as a dermatologist in the state of North Carolina.