Welcome / Patient Forms
Patient Forms
We look forward to caring for you at Allergy, Asthma & Immunology Center. You can expedite check-in and often allow for more time face-to-face with the doctor if you complete forms before arriving for your appointment. Please print or send to us via email.
Note that you can fill out your medical history online through our patient portal at https://health.healow.com/aaictx or via the Healow App with practice code BBGECA. Please fill out both questionnaires: Medical History and Surgical and Allergies.
- New Patient Complete packet – use this form if you DID NOT submit questionnaires through the portal
- New Patients with Portal Medical History – use this form if you did submit questionnaires through the patient portal
- HIPAA notice of privacy practices document – HIPAA-Notice-of-privacy
- Existing Patient Forms
- Medical release request forms – to AAIC (incoming patients)
- Medical release forms – from AAIC
Your health is our priority
Allergy, Asthma and Immunology Center can be reached during normal office hours by phone.