Thank you for choosing the Allergy and Asthma Center as your treatment facility. We have provided downloadable versions of all the necessary forms for you to begin treatment with us. Those forms include:
For telemedicine patients, at the TIME of your appt, please go to:
- www.doxy.me/drallergist for your appt with Dr. Wasan or;
- www.doxy.me/amyfeldmanpa for your appt with Amy Feldman, PA.
New Patient Forms
For New patients, please print and complete the two sets of forms below.
- New Patient Forms
- Telemedicine Patient Consent Form
- Antihistamines to Stop Five days Prior to Appt
- Release of Medical Information
- Information for Patients on Beta Blockers
Established Patients
Outside Shot Form
Allergy Shot Forms
Other Forms
- Food and/or Medication Challenge Instructions
- New Patients and Established Patients: Credit Card Policy
- Covid Questionaire
- Patient Authorization for Communication
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For telemedicine patients, at the TIME of your appt, please go to:
- www.doxy.me/drallergist for your appt with Dr. Wasan or;
- www.doxy.me/amyfeldmanpa for your appt with Amy Feldman, PA.
New Patient Forms
For New patients, please print and complete the two sets of forms below.
- New Patient Forms
- Telemedicine Patient Consent Form
- Antihistamines to Stop Five days Prior to Appt
- Release of Medical Information
- Information for Patients on Beta Blockers
Established Patients
Allergy Shot Forms
- For Those Patients Receiving Their Allergy Shots at an Outside Medical Facility
- Allergy Shots Consent Form
- Allergy Serum Remixing Form (for shot patients)
- Changing Allergist Form
Other Forms
