New Patient Packet
Download and print our new patient packet.
This packet includes most of the forms and paperwork you will need at your first visit,
and will save you an estimated 15 minutes of paperwork before your visit.
Please chose the forms below that you wish to download or print:
- New Patient Welcome Letter
- New Patient Registration Form
- New Patient Checklist
- (this will help you prepare for your visit)
- Worksheet for Contacting Your Insurance Company
- (this will help you contact your insurance company and determine your coverage)
- Maps to our offices
Fill Out the Registration Form Online & Save Time at Check In
Authorize and direct The AAC to disclose protected health information:
If the patient is unable to give authorization because of age, physical condition or otherwise, or if you wish someone other than yourself to have access to your Protected Health Information. Under the federal privacy rules this form must be completed, and submitted to our office (don't forget to sign it).
- Proxy Consent To Treat Minors Form
- (allows minors under the care of a proxy to receive routine medical care)
- Authorization to Disclose Health Information
You will need Adobe Reader® to view and print these documents
Copyright 2008. The Allergy and Asthma Center, PC. All rights reserved.
The Allergy and Asthma Center, and Leaf Logo are registered trademarks of
The Allergy and Asthma Center, PC
The Allergy and Asthma Center, and Leaf Logo are registered trademarks of
The Allergy and Asthma Center, PC