Allergy & Asthma Consultants, Ltd.

Online Forms Library

New Patient Enrollment Packet
These forms are for your initial appointment.  Please read and complete ALL forms in this file, prior to your initial appointment.  The more information the doctors have about your symptoms, the sooner we should be able to help you.

Privacy Notice
This form is for all of our patients.  Please read our HIPAA Privacy Policy.

Medical Records Release Form "TO" Allergy & Asthma Consultants, Ltd.
If you have medical records from another physician's office that you feel may be relevant to your allergy appointment, complete this form.  You can either bring it to your initial appointment or with time permitting, give it to your referring physician so your records will be available for review during your appointment.

Medical Records Release Form "FROM" Allergy & Asthma Consultants, Ltd.
If you need medical records sent to another physician's office, (example: due to relocation out of state) then you can complete this form.  You can either bring it to one of our offices or fax it to us.  (See our locations page for addresses and fax numbers.)

Vial Authorization Form
This form is for those patients that have already been seen at Allergy & Asthma Consultants and have been advised that they may benefit from allergy injections.  We will need this completed authorization form prior to making your allergy serum(s).

These forms are in PDF format which requires you to have Adobe Reader to view and print them.