Registration Forms
Please print and complete attached form to bring on the day of your first visit.
Regis Forms 2017.pdf
Adobe Acrobat Document 223.5 KB

New Patient Forms and Information

Before Your Visit

***Please be aware that your Insurance Plan may require you to obtain a referral from your Primary Care Provider (PCP) prior to your office visit.  All referrals are the patient’s responsibility.  If you are unsure if you need a referral, please call the office, and we would be glad to assist you.***
 
Your First Visit

Please do not take any medications that contain antihistamines for at least 72 hours prior to your visit.  Antihistamines can interfere with testing of allergies and render the skin test less reliable. If your symptoms are intolerable without these medications, please continue to take all your medications and the doctor will still examine you and find an alternative method to pursue allergy testing.  List of medication to be discontinued:
  • Prescription antihistamines, such as desloratadine (Clarinex), fexofenadine (Allegra), levocetirizine (Xyzal), hydroxyzine (Atarax), or cyproheptadine (Periactin)
  • Over-the-counter antihistamines (Benadryl, Claritin, Chlor-Trimeton, Zyrtec, Alavert, etc.) 
  • Certain antidepressants, such as amitriptyline and doxepin (Sinequan) 
  • Heartburn medications, such as cimetidine (Tagamet) and ranitidine (Zantac)
  • The nasal antihistamine spray azelastine (Astelin)
Do not stop taking:
  • Cortisone nasal sprays (Flonase, Nasonex, Nasacort AQ, Rhinocort, Veramyst etc.)
  • Asthma medications (Albuterol, Proair, Ventolin, Flovent, Singulair, Advair, Symbicort etc.)
  • Antibiotics
  • Eye drops for allergy (Patanol/Pataday, Optivar, Elestat, Zaditor, etc.)
  • Decongestants (Sudafed, Sudafed PE, etc.)
  • Oral steroids (Prednisone, Medrol, Prelone, Orapred, etc.)
  • Any other medications for diabetes, blood pressure, birth control, arthritis, etc.