Allergy Sleep & Lung Care New Patient Forms

Welcome to Allergy Sleep & Lung Care! Your wellness is our goal and we will work with you to manage your symptoms.

At Allergy Sleep & Lung Care, we are specially trained to help you maintain optimum health. Everything we do is driven by a patient care philosophy that is the essence of our practice:

  • Compassionate, sensitive, patient-focused care: Your special needs, concerns, and lifestyle, and those of your family, will guide our treatment planning.
  • Excellent and cost-effective service: The care you receive from us will be on par with the highest national standards. It may include traditional medicine, complimentary treatments, and nutrition and fitness therapies.
  • Access to innovation: We stay up to date with the latest treatment options. If you are eligible, we can provide access to enrollment in clinical trials.

Our role is to assist you and your primary care doctor in evaluating the needs related to any allergy, sleep, and lung conditions. Your comprehensive care may require a team involving several doctors. We’ll do our best to help you manage the team to make it as easy and convenient as possible for you.

We promise that you will always be able to reach a doctor with your concerns. If you have any questions, please call us directly at (239) 932-3023.

Thank you for trusting us to help maintain your health. Our mission won’t be achieved until you feel better. Now you can breathe easier.

Welcome Letter & Patient Registration

New Patient Registration Packet

Step-By-Step Instructions:

  1. Click on “New Patient Registration Packet” to Open as PDF  (Above)
  2. Review the Three Documents
  3. Print Forms:
  4. Fill Out Forms
  5. Bring Forms to Initial Appointment

What To Bring To Your First Appointment

  • Picture ID
  • Insurance Card(s)
  • Referral/Authorization Form (if required by insurance)
  • List Of Medications:
    1) Current
    2) Over-The-Counter Medications
    3) Inhalers You Are Using – Include Dose & Frequency
    (You may want to bring all medications with you to the appointment)
  • Important Information About Your Medical & Surgical History
  • Any Recent X-rays Or Medical Records Pertinent To Your Visit
  • Sleep study report and PAP compliance data in printed form or SD card from PAP machine

Allergy Sleep & Lung Care is a Medicare provider and accepts many major insurance plans.  We ask that patients whose insurance policies require referrals/authorizations obtain them prior to scheduled appointment. Those patients who do not present a referral/authorization at the time of visit will be asked to reschedule or pay out of pocket until such time as referrals are provided.

If you have any questions regarding which insurance plans we accept or any billing concerns, please call us at the phone number below. Any questions regarding your coverage and benefits should be directed to your insurance company.

Have questions about the forms or what to bring to your appointment? Contact us today or call (239) 437-6670.

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