The following downloads are forms that you will need to print out and fill in prior to your first office visit.
Printing these out and signing them before your first visit will save you time! Please feel free to call our office if you need any assistance.
ALLERGY ASTHMA EAR NOSE AND THROAT
AAENT Patient History Form
This form needs to be fully filled out prior to your first appointment.
AAENT Patient Privacy Disclosure Form
This form needs to be fully filled out prior to your first appointment.
AAENT Patient Financial Waiver Form
This form needs to be fully filled out prior to your first appointment.
AAENT Patient Financial Responsibility Form
This form needs to be fully filled out prior to your first appointment.
AAENT Patient Care Registration Form
This form needs to be fully filled out prior to your first appointment.
AAENT HIPPA FORM
This form needs to be fully filled out prior to your first appointment.
ALLERGY ASTHMA CARE
AAC New Patient Financial Form
This form provides you with our financial policies.
AAC New Patient HIPAA Form
This form provides you with information about your rights to privacy and our responsibilities to you regarding the release of any of your medical information.
Adult Medical History Form
This form needs to be fully filled out prior to your first appointment.
Pediatric Medical History Form
This form needs to be fully filled out prior to your child’s first visit with us.
AAC New Patient Info Form
This form gives us information about you. It provides us with insurance and other necessary financial information so that we can file your office charges with your insurance carrier.