Welcome, New Patient!
- 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:
Read, Complete, Sign and Date.
Adobe Acrobat document [84.3 KB]
Please fill out all sections except beyond section K. Those are for the physician to fill out.
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 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)
- Desloratadine (Clarinex)
- Fexofenadine (Allegra, Allegra-D)
- Loratadine (Claritin, Claritin-D, Alavert)
- Levocetirizine (Xyzal)
- Patanol eye drops
- Prednisone, Methylprednisolone
- Over-the-counter "Allergy" Medications
- Sleeping aids – non-prescription (if they contain antihistamines)
- Brompheniramine (Bromfed, Rondec, Dimetapp)
- Diphenhydramine (Benadryl)
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: