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New Patients : Download, Print, Fill out Forms

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NEW PATIENT FORMS – DOWNLOAD, PRINT, AND FILL THESE OUT BEFORE APPOINTMENT:

DOWNLOAD ALLERGY HISTORY FORM
DOWNLOAD PATIENT INFORMATION SHEET

Additional Information:

  • Billing and appointment information for your first visit
  • Medications to avoid before allergy skin testing
  • What to expect from your visits
  • Financial policy
  • Credit card on file policy
  • Download Consent to Treat Minor (if not accompanied by parent)

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Address

  • Fairfield Office
    55 Walls Drive, Suite 105, Fairfield, CT 06824
  • Trumbull Office
    35 Corporate Drive, Suite 1115, Trumbull, CT 06611
  • allergyasthmact@gmail.com
  • (203) 259-7070
  • (203) 445-1760

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  • Home
  • Our Services
    • Our Services
    • Telemedicine Visits
    • Food Desensitization / Oral Immunotherapy
  • Physicians And Providers
    • Hospital Affiliations
  • Offices & Hours
    • Managed Care & Insurance
    • Our Reviews
  • Pay Balance Online
  • Resources
    • NEW Patients: Download, Print, Fill out Forms
    • Baked Milk And Baked Egg Challenge Recipes
    • Financial And School Forms Policies
    • Food Allergy Center
    • Food Allergy Resources
    • Preparing For Oral Challenges
    • What About Allergy Drops?
    • Peanut Oral Immunotherapy Info
  • Contact Us
Pay Balance
New Patients
Hours & Location
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