New Patients:

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To expedite your check-in process as a new patient, please download the New Patient Packet below. Please bring the completed forms, your insurance card, and a photo I.D. (i.e. driver’s license) to your appointment.

• Patient Registration Form
• Health History Form
• Conventional Immunotherapy Information/Consent Form
• RUSH Immunotherapy Information/Consent Form
• Extract Vial Order Form (Administered by our office)
• Extract Order Form (Mail out)
• Medical Records Request Form
• Notice of Privacy Practices
• HIPAA Patient Consent Form
• ACT Form
• ROS Form