66-year-old female with a history of HTN, GAD,  skin melanoma who came for a first tie consultation , she states she changed insurances recently and needs new doctor for her refills. oon the physical examination there is evidence of a  lesion on the left side of her face asymmetrical, with irregular border, changes on coloration and with elevation, she states she noticed since a while but has not been able to take a look at it. Patient education was provided, referral to dermatologist to consider skin biopsy recommended as soon as possible, we sent refill for medications.