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Phone: 952-395-6850 | Fax: 952-395-6870
Waconia Office: 582 Cherry Drive • Waconia, MN 55387
Shakopee Office: 1515 Saint Francis Avenue • Shakopee, MN 55379

New Patient Appointment Request

If you are a new patient to our practice, please call 952-395-6850 to schedule or use the form below. If you leave a message, please include a good time to call you back. We return phone calls within 1 business day.

Important:  As you are responsible for any out-of-pocket expense (copay, deductible, co-insurance), it is your responsibility to verify with your insurance before your appointment whether the medical provider you are seeing is in-network or out-of-network for your specific plan and whether your insurance requires a referral. Please verify these with your insurance plan directly by checking your insurance website or by calling their customers service number on the back of your insurance card.

Click on the Patient Center tab for more information about insurance, our credit card on file policy, and privacy policy. Please print and fill out all patient registration forms and bring them to your first appointment. This will expedite the registration process.

Patient Information
Patient Name:
Date of Birth:
Email Address:
Best Time to Call: Morning (AM)
Afternoon (PM)
Reason for Visit:
Insurance Name:
Name of Primary Beneficiary:
Insurance ID Number:
Insurance Group Number:

Our Convenient Offices

Darabi Dermatology has an offices conveniently located in Carver County and Scott County to make it easy for our patients to access our practice for high quality dermatologic care.