NEW PATIENT INFORMATION
Welcome to our office! We are delighted to meet you and look forward to your visit.
Prior to your appointment, we ask that you print and complete these forms.
- New Patient Registration Form
- Patient History Form
- Notice of Privacy Practices Acknowledgement Form
Notice of Privacy Practices
- Financial Policy and No Show/Missed Appointment Policy
INFORMATION TO BRING TO FIRST APPOINTMENT
- The four forms you printed and completed
- Current insurance card
- Current photo ID
- Physician referral forms, if required by your insurance
- List of your current prescription and over-the-counter medications, with the dose and frequency of each one
- All relevant medical records–blood test results, x-ray reports and health care provider reports
We kindly request that you arrive 5 minutes before the appointment time in order to allow the staff to complete your registration. The first appointment generally takes 2 hours.
If you expect allergy testing to be done at the first appointment, please do not take any antihistamine medication for at least 72 hours before your appointment. Antihistamine medications prevent the skin from showing a positive result. If you take any antihistamine within 72 hours of the appointment, testing may not be performed and a follow-up appointment would be needed. Do not stop taking any other medications. If either you start any new medications, or if an illness begins, during the 72 hours before your scheduled appointment, please call our office and let us know.
INSURANCE AND PAYMENT INFORMATION
If you have any specific questions regarding your health insurance coverage/benefits and referrals, you should contact your health insurance company and ask specifically about whether your coverage includes evaluation by an allergist and allergy testing.
If you have HMO or POS coverage through your health insurance company and you are required to have a written referral in order to be evaluated by us, you must confirm with us that our office received it before the appointment.
Your health insurance company may require a co-payment at the time of your appointment. You are required to pay any co-payment at the time of the office visit – according to the terms of your health insurance coverage and our contractual obligation with the insurance companies.
You are responsible for charges not covered by your health insurance. When necessary, we will work with you to set up a payment plan.
If you have any questions about either our billing practices or which insurance plans we accept or the costs for your appointment, please contact us at 847.579.4265.
GENERAL OFFICE POLICIES
If there are severe weather conditions in our area, please call our office for possible changes in office hours.
If you need to change or cancel your appointment, we kindly require that you contact our office at least 24 hours before your scheduled appointment in order to accommodate other patients’ schedules. If you need to notify us after our regular business hours, you may leave a message on our office management voicemail at 847.432.0200.
Please call us if you anticipate that you will be more than 10 minutes late for any appointments.
Patients who receive immunotherapy injections (“allergy shots”) can walk in for their treatment. They do not need an appointment with the nurse, unless the physician also needs a prescheduled office visit to review the response to the treatment. Allergy shots are given on weekdays when the office is open, including the noon hour, as well as during Saturday office hours. No allergy shot is given if a patient arrives after the close of business hours.
Prescription refill requests are only taken care of during office hours.
When the office is closed, the physician may be paged for an urgent or severe medical problem through the office phone system.