Welcome, New Patient!

PLEASE BRING:

  • Photo I.D.
  • Insurance Card
  • Completed New Patient Allergy Evaluation Form
  • Completed Registration Form

 

  • If you are currently taking several medications, it would be helpful to have a list indicating the name of the medication & strength.
  • Medical records from previous physicians would also be useful.

The appointment may last 2-3 hours.

 

Please print & complete the forms below:

Registration Form
Read, Complete, Sign and Date.
Patient Registration.pdf
Adobe Acrobat document [84.3 KB]
New Patient Allergy Evaluation
Please fill out all sections except beyond section K. Those are for the physician to fill out.
ALLERGY_SURVEY-10.pdf
Adobe Acrobat document [160.1 KB]

"ADDITIONAL NOTES" margin is for the physician. Please print the survey on 4 pages (not double sided).

Notice Regarding Privacy of Personal Health Information
Notice Regarding Privacy of Personal Hea[...]
Adobe Acrobat document [125.2 KB]

If possible, please do not take any anti-histamines 5 days prior to your appointment. They will interfere with allergy testing.  

 

Examples of medications: * (This is not a complete list) *

  • Atarax or generic Hydroxyzine
  • Azelastine (Astelin, Astepro) Nasal Spray
  • Patanase (Olopatadine Hydrochloride) Nasal Spray
  • Cetirizine (Zyrtec, Zyrtec-D)
  • Desipramine
  • Desloratadine (Clarinex)
  • Doxepin
  • Dymista
  • Fexofenadine (Allegra, Allegra-D)
  • Imipramine
  • Loratadine (Claritin, Claritin-D,  Alavert)
  • Levocetirizine (Xyzal)
  • Patanol eye drops
  • Periactin
  • Phenergan
  • Prednisone, Methylprednisolone
  • Tavist
  • Zonalon

Over-The-Counter

  • Over-the-counter "Allergy" Medications
  • Sleeping aids – non-prescription (if they contain antihistamines)
  • Actifed
  • Aller-Tec 
  • Brompheniramine (Bromfed, Rondec, Dimetapp)
  • Chlor-Trimeton
  • Diphenhydramine (Benadryl)

 

Asthma Patients:

Please click the link to fill out the Asthma Control Test. Print the results and bring with you to your appointment.

 

If possible, please discontinue bronchodilators (i.e. ProAir/Ventolin/Albuterol) the day of the appointment

Co-payments are due at the time of the visit. We accept: