Patient Forms

Please fill out the forms that you were advised to complete which will be submitted electronically. Come prepared with any relevant medical records, such as hospital records, previous allergy testing, radiology and/or laboratory results. We request you to arrive 30 minutes prior to your appointment time and do not wear strong scents. 

Online Patient Forms

  • 1. Telemed Adult Patient Registration Form

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  • 2. Telemed Minor Patient Registration Form

    For new patients younger than 18 years.

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  • 3. Adult Patient Registration Full Packet

    For new adult patients visiting in office.

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  • 4. Minor Patient Registration Full Packet

    For new minor patients visiting in office.

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  • 5. Adult Patient Registration

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  • 6. Minor Patient Registration

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  • 7. Document / Picture Upload

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  • 8. Informed Consent for Telemedicine

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  • 9. Medical Health History

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  • 10. Consent to Treat a Minor

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  • 11. Authorization to Release Information

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  • 12. Antihistamine List

    Click the button to download the antihistamine list

    Download

  • 13. Patient Survey

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  • 14. Immunotherapy Information and Consent

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  • 15. Authorization to Make Antigen

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  • 16. Release of Antigen Consent Form

    Download

  • 17. Environmental SLIT Renewal Form

    Authorization for SLIT renewal

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  • 18. Food SLIT Annual Renewal Form

    Authorization for SLIT renewal

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  • 19. OFC Acceptable Foods List

    Click the button to download the Foods list

    Download

  • 20. Full PFT Patient Instructions

    Click button to download PFT instructions

    Download