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Patient Forms

PPAA New Patient Form (PDF 311 KB)

PPAA Medical History Form (PDF 781 KB)

PPAA Minor Patient Consent Form (PDF 301 KB)

Note to New Patients

In consideration of our asthma patients, we request that all patients and visitors not wear perfume or cologne. - Thank you.

Please be prepared to list your medications and recent problems.

Also any recent x-ray dates and locations are helpful.

REMEMBER

No antihistamines 7 days prior to appointment – unless you have hives. Stay on your asthma medications.

  1. Bring your insurance card/cards.
  2. Bring copay if you have one.
  3. Referrals - This is standard with most HMO insurance. Call your primary physician to verify referral has been sent to our office by your insurance company.
  4. Please bring your referral or we may have to reschedule your appointment if we do not receive the referral in our office.

Call during Office Hours with ANY Questions.