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Registration Form

Patient Details
Patient Employer
Emergency Contact Name
Billing and Insurance, Primary Health Insurance
Responsible Party

How did you hear about Dr. Milton D. Moore?

Reason For Visit
Current Medications
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skin
Past Medical History
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Cosmetic Procedures:

Testimonials

test
Brad Scarface Jordan (recording artist)

I started getting a lot of acne and razor bumps on my face. I talked to a barber friend of mine and he told me to come see Dr. Moore, so I go online to look up Dr. Moore and schedule my appointment. My appointment was scheduled for a month out. Dr. Moore’s staff squeezed me in within 3 weeks. Everything was gone.He is a great doctor and a friend of mine. He did what Pro Active couldn't do. There is a difference between going to someone who does different ethnic skins. A big difference. Pro Active is good but Dr.Moore is better.