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New Patient Appointment Forms
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New Patient
Information Sheet (440KB) |
Please print out and complete this form and bring it with you to your initial visit.
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Insurance Information Sheet for New Patients (440KB) |
Please print out and complete this form and bring it with you to your initial visit
along with your insurance card.
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Information Update
Sheet
(450KB) |
If you are a current patient and any information such as your name, address, employer,
or insurance has changed, please print out and complete this form and bring it with
you to our office along with your new insurance card.
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Release of Records
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Release
of Records to Regional Allergy (620KB) |
Use this form if you want to send records from your current/previous physician to
Regional Allergy. Please print out and complete this form and send it to your current/previous
physician so that records may be transmitted to our office.
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Release
of Records from Regional Allergy (450KB) |
Use this form if you want Regional Allergy to send your records from our practice
to someone else. Please print out and complete this form and mail it to 14 McDowell
Street, Asheville, NC 28801 or fax it to (828) 253-0069 so that we may transmit
your records to the designated party.
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Download
Acrobat Reader |
In order to view or print our forms, you'll need to have Acrobat Reader installed
on your computer.
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