Allergy and Asthma Specialists
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What to Bring to Your Appointment

  • Your insurance card
  • Physician referral forms, if required by insurance
  • List of prescriptions and/or over-the-counter medication, including dose and frequency
  • Information about your medical and surgical history
  • Recent x-rays or relevant records
  • Up-to-date Registration and Medical History forms

For your convenience, all registration forms, medical history forms, and skin eruption forms are available for download below. Adults who use their parents' insurance should fill out a Minor Registration Form. Please bring your completed forms to the office for your first visit, and update your information yearly.  

Insurance and Payment Information

We are providers for most PPOs and HMOs, including BCBS, Prudential, St. Vincent CMO, Aetna US Healthcare, Cigna, Sagamore and many more. We accept Medicare assignment. If you are unsure if we are in network, please call member services on the back of your insurance card and inquire with your insurance company.  

As a courtesy to our patients, we will submit charges to your insurance company. Co-payment is expected at the time of visit.  

adult_registration_form.docx
File Size: 18 kb
File Type: docx
Download File

adult_registration_form.pdf
File Size: 39 kb
File Type: pdf
Download File

minor_registration_form.docx
File Size: 18 kb
File Type: docx
Download File

minor_registration_form.pdf
File Size: 182 kb
File Type: pdf
Download File

new_patient_skin_test_instructions.docx
File Size: 18 kb
File Type: docx
Download File

new_patient_skin_test_instructions.pdf
File Size: 187 kb
File Type: pdf
Download File

new_patient_medical_history_form.docx
File Size: 207 kb
File Type: docx
Download File

new_patient_medical_history_form.pdf
File Size: 138 kb
File Type: pdf
Download File

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