Patient Information and Forms

Your first visit to Comprehensive Allergy and Asthma Care establishes a vital foundation for our relationship with you. During your first visit, we make sure to obtain important background information about your medical history and give you time to get to know your doctor.

To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, financial policies and more.

Mission Statement

Our practice is working together to realize a shared vision of excellence in medicine.

To fulfill this mission, we are committed to:

• Listening to those we are privileged to serve.
• Earn the trust and respect of our patients, profession and community.
• Exceed your expectations.
• Ensure a creative, challenging and compassionate professional environment.
• Strive for continuous improvement at all levels.

Current Patient Forms

Practice Administrative and Financial Forms

Patient Medical Questionnaire

Patient Demographic Form

HIPAA Medical Record Request

HIPAA Over 18 Patient: Parent Information Consent Form

CAAC Physician Peer-to-Peer Agreement

New Patient Forms

Please fill-out and print or download & save forms and fill out the following forms and e-mail to [email protected] so we can expedite your first visit.

New Patient Intake Form

Health Information Exchange Consent Form

Patient Financial Responsibility Form

Practice Administrative Agreement

All new patients MUST complete the Practice Administrative Agreement prior to a Medical Chart Review and the scheduling of the first patient appointment. Please click the links below to acknowledge and sign the agreement and financial documents..

Practice Administrative Agreement

Practice Administrative Fee Payment Site

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

What To Expect

Being well-prepared for your appointment will ensure that the doctor has all the information necessary to provide you the best possible care. It will also help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing our Patient Education section. We look forward to your first visit.