Documents

Please click below for a .pdf file of our New Patient Packet, which contains all the forms and documents you will need for your first visit, including:

• Informed Consent
• Special Medication Instructions for Allergy Testing
• Medical Record Requests and Patient Completion Forms Policy
• Authorization to Pay Benefits to Physician
• Carolina Asthma & Allergy Center Financial Policy

New Patient Packet

New Patient Packet – Español

Shot Packet

Shot Packet – Español

Allergy Tracker Information

Allergy Tracker Information – Español

Request for Access to Protected Health Information (to CAAC)

Request for Access to Protected Health Information(from CAAC)

Consent For Adult Other Than Parent to Accompany Minor

Appointment Referral Fax Form

Appointment Referral Fax Form – Hickory Office

Student Asthma Action Card

Quick Report Card — Asthma and Allergy School Assessment for Students

Notice of Privacy Practices (NOPP) document