(540) 343-7331

(434) 846-2244

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Patient Forms

Please bring these completed forms with you to your office visit. Doing so can reduce time spent in our office for both new and returning patients. 

 

If you prefer, we will gladly send you the forms via US Mail. Simply contact our office. 

This includes some additional resources that will help you know what to expect for your first visit. It also includes a list of medications that you should not take prior to testing. If you have any additional questions, our friendly staff is always willing to help. 

Please fill out this packet and bring it with you to your first visit. You can also fax it to our office. This packet also includes the Welcome Letter. 

This policy outlines our financial policies and your financial responsibilities. If you have any questions about the policies, please feel free to call our office. 

This document outlines how we handle your personal health information. 

New Patients: Please review this document before signing the acknowledgement form in the New Patient Packet. 

We strive to exceed your expectations in all that we do. Please take some time to rate your recent experience with us. 

Please fill out this document and return it to our office if any of your persoanl information has changed since your last visit. You can also update your information on our Patient Portal. 

This form authorizes us to release your Personal Health Information (PHI). A signed copy is required for us to release your information to anyone besides you. 

If you are transferring from another allergist, sign this form and include it with a request for your records to be transferred to us.