| 248-693-4444 |
| Allergy & Asthma Treatment Center, PLC |
FORMS
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Questionnaire For New Patients: Click here to download and print a
detailed questionnaire. Take your time to answer the questions and bring it
with you at your first visit.
detailed questionnaire. Take your time to answer the questions and bring it
with you at your first visit.
Release of Health Care Information: Click here to download a Release of
Health Care Form if you would like us to have access to medical records
from your other physician(s). Please fill and sign it as instructed. You could
mail or fax it directly to your other physicians to request a copy of your
medical records ahead of your visit or bring it with you.
Health Care Form if you would like us to have access to medical records
from your other physician(s). Please fill and sign it as instructed. You could
mail or fax it directly to your other physicians to request a copy of your
medical records ahead of your visit or bring it with you.
Allergy Skin Prick Testing Instructions: Click here to download instructions
for the allergy skin test. Certain medications (with antihistaminic property)
should be stopped prior to the test. (See also Procedures for more
information about this test and contact office if any questions)
PATCH TESTING: This test should not be confused with the skin prick tests.
If you need a skin patch test which is performed in cases of contact
dermatitis (and sometimes atopic dermatitis), you should be off any oral
steroid such as prednisone. Please contact our office to get more details as
this test requires special scheduling.
for the allergy skin test. Certain medications (with antihistaminic property)
should be stopped prior to the test. (See also Procedures for more
information about this test and contact office if any questions)
PATCH TESTING: This test should not be confused with the skin prick tests.
If you need a skin patch test which is performed in cases of contact
dermatitis (and sometimes atopic dermatitis), you should be off any oral
steroid such as prednisone. Please contact our office to get more details as
this test requires special scheduling.
Notice of Privacy Practices: Click this link to access and review a copy of
our Notice of Privacy Practices. You do not have to print it.
Once you have reviewed it, please sign the form acknowledging that you
had access to this notice and only bring this one page form to your
appointment: Acknowledgement form.
Financial Policy: Please click here to read, or download, print and sign the
practice financial policy. We will work with you to determine your insurance
plan coverage. We will certainly work with you in case of financial hardship
or lack of adequate coverage.
our Notice of Privacy Practices. You do not have to print it.
Once you have reviewed it, please sign the form acknowledging that you
had access to this notice and only bring this one page form to your
appointment: Acknowledgement form.
Financial Policy: Please click here to read, or download, print and sign the
practice financial policy. We will work with you to determine your insurance
plan coverage. We will certainly work with you in case of financial hardship
or lack of adequate coverage.