Home
  Appointments & Office      hours
  Nurse Practitioners
  Staff
  The Storms Clinical     Research Institute
  The Cough Center
  Sinus CT Scans
  Satellite Clinics
 

Athletes with

    Allergies and Asthma

  Patient Forms
Patient Educational             Information
  Contact us
   
 
 

 

 

 

 

 

 

 

 

 

     

 Patient Forms

     

  Please arrive to the clinic at least 15 minutes prior to your scheduled appointment.  This is extremely important as you will need to sign additional forms and we will need to make a copy of your insurance card.

Prospective patients are encouraged to fill in the following forms  and return  them to our clinic by:

Fax: 719-955-9595   or

E-mail: forms@stormsallergy.com

   
  Help with On-Line Forms  
   


As soon as you open a form, hit the TAB button and continue to use the TAB button while you complete the form.  DO NOT hit ENTER.

If you have any difficulty, please call 719-955-6000 and ask for Kim Clements in the back office.

 

 

   



Patient Registration Form

Medical History

 

 

This website was developed  and is managed by SRxA Digital Communications Division

Copyright © The William Storms Allergy Clinic 2005-2009 - All Rights Reserved