Patient Information

Forms

For your convenience, you may download, print and fill out the following forms and bring them to your first appointment.

Pre-Registration Form

Clinic Policies

Welcome to our clinic and thank you for choosing us to serve you. Our clinic is devoted to providing personalized treatment of asthma, allergies, and related conditions. We welcome questions, as our basic philosophy is that an educated patient will be better able to make informed decisions about his/her health care. In particular, we follow the national guidelines for care of asthma which stress close cooperation between the patient and the health care team.

Appointments:

All patients, except for emergencies, are treated on an appointment basis. Your appointment time is reserved for you so please give us 24 hour advanced notice if you need to cancel or reschedule.

Questions & Prescriptions:

Please call if you have questions about your allergy/asthma care. We will only refill prescriptions during regular office hours and require that patients be seen at least once a year. In general, it is best to request refills of your prescriptions at the time of your visit.

Fees:

We strive to keep our fees as reasonable as possible consistent with quality medicine. Fees for allergy/asthma care vary widely depending on the types of tests required and the nature of treatment recommended. We welcome a discussion of fees prior to treatment.

Insurance:

Please be sure to bring your insurance card to your first visit and notify us of any changes in your insurance coverage. We participate in a variety of health care insurance programs which aid in the payment of your medical costs. Should there be a problem with an insurance claim, we suggest that you first direct your questions to your insurance carrier. Our office will be happy to help if we can be of any assistance in resolving a billing problem, but we must stress that the financial responsibility for payment rests with you, the patient.

Credit Policy:

We require that deductible, co-payment, and coinsurance are due at the time of service. This applies to all our patients, whether new or established. If you are unable to make all of your payment at the time of service, we will be happy to make monthly payment arrangements for you utilizing your credit card or auto-debit of your checking account. We urge you to notify us if you have a temporary financial problem to help us avoid other methods of collection. We accept MasterCard/Visa/Discover payments. A $30.00 fee will be charged for any checks returned with non-sufficient funds.

Emergency Care:

We have found that many severe asthma flare-ups can be avoided by proper attention to triggering factors and recognition of the early stages of asthma symptoms. Usually, this will allow for early treatment. On occasion, though, you may experience a severe worsening of your asthma or allergies which will require extra care. You should first refer to your personal Asthma Action Plan or other written instructions provided to you at your initial visit. We are also available for telephone consultation and encourage you to call for advice as needed. In an after hours emergency, you should call your primary care physician or go to the emergency room.