Welcome, New Patient!

PLEASE BRING:

  • Photo I.D.
  • Insurance Card
  • Completed New Patient Allergy Evaluation Form (see below)
  • Completed Registration Form (see below)
  • Any pertinent medical records the doctor might find helpful.
  • Prescription medication lists, photos, or anything else that may be useful.

Your first appointment can involve testing and other requirements, so plan on being in our office for 1-3 hours.

 

If you cannot print and fill out the two required new patient forms, you must arrive for your appointment 20 minutes early.

 

If you need to cancel or reschedule your appointment, please inform us at least 24 hours in advance. If you call after business hours, you can leave a message.

 

New Patient Paperwork

*Please print both documents below!*

1. Registration Form
Click the .pdf link below to download the file and print. Fill out all the information you can. Please remember to sign the bottom.
Patient Registration Form.pdf
Adobe Acrobat document [84.3 KB]
2. New Patient Allergy Evaluation
Click the .pdf link below to download the file and then print. Do your best to fill out all sections but you can stop at section K.
Allergy Evaluation Form.pdf
Adobe Acrobat document [160.1 KB]

 

Are You Taking Antihistamines?

If possible, please do not take any antihistamines for at least 5 days prior to your appointment as they interfere with possible allergy testing.

 

Examples:

*(Note: This is not a complete list)*

 

Prescription Medication

 

  • Hydroxyzine (Atarax, Vistaril)
  • Azelastine (Astelin, Astepro, Optivar)
  • Olopatadine  (Pazeo, Patanol)
  • Dymista
  • Cyproheptadine (Periactin, Peritol)
  • Promethazine (Phenergan)
  • Doxepin (Zonalon)

Over-The-Counter

  • Over the counter “allergy” medications

  • Over the counter "sleep aids"

  • Benadryl

  • Diphenhydramine (Benadryl)

  • Cetirizine (Zyrtec, Allertec)

  • Loratadine (Claritin, Alavert)

  • Desloratadine (Clarinex)

  • Fexofenadine (Allegra)

  • Levocetirizine (Xyzal)

  • Brompheniramine (Bromfed, Rondec, Dimetapp)

  • Chlorpheniramine (ChlorTrimeton)

  • Clemastine (Tavist)

  • Triprolidine

 

Note:  If you are unsure whether your medication qualifies as an antihistamine; you can check the medication bottle and pamphlet, ask your provider or pharmacist, or call the office during regular business hours.

 

 

Are You Taking Steroidal/Corticosteroidal Medication?

Please inform the doctor if you are currently taking oral steroidal/corticosteroidal medication, or if you have taken any in the past 3 weeks.

 

Examples:

*(Note: This is not a complete list)*

 

Prescription Medication

  • Prednisone
  • Prednisolone
  • Hydrocortisone
  • Methylprednisolone
  • Dexamethasone
  • Cortisone

 

                                                                                                  Attention Asthma Patients:

Asthma Control Test

After clicking on the link above, please fill out the test, print the results, and bring it with you to your appointment.

 

If possible, please also try not to use any bronchodilator inhalers (examples; ProAir/Ventolin/Albuterol) on the morning of the appointment

 

 

Copays are due at the time of the visit.

 

We accept:

Health Privacy
Click here to view a notice regarding the privacy of your personal health information.
Notice Regarding Privacy of Personal Hea[...]
Adobe Acrobat document [125.2 KB]