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Patient Forms

Please click to download,  fill out required forms, and then bring them with you for your appointment. It is very important that these forms be filled out PRIOR to your scheduled appointment time. 

Thank you.

  • Peanut Desensitization Consent
  • OIT Frequently asked questions
  • OIT home dosing instructions
  • ACAAI peanut desensitization brochure
  • Peanut OIT coding info for insurance companies
  • OIT Daily Diary
  • General OIT FAQs

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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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