Patient Responsibility

Please, read and sign all forms.

Please prepare for this appointment by bringing:

Health Insurance Card/Information
If you cannot produce your insurance card at time of treatment, payment for services will be required, which can then be claimed on your insurance.
Photo ID or Driver's License
For patients 16 and under, written permission for evaluation and treatment from a parent or legal guardian if one of them is not accompanying the child
List all medical conditions that you are afflicted with (current and past)
List all medications you are taking names, doses, and frequencies - REMEMBER TO INCLUDE ALL OVER THE COUNTER MEDICATIONS, VITAMINS, HERBAL PRODUCTS AND NUTRITIONAL SUPPLEMENTS
List all drug allergies-Names, Dates and types of reactions
List all surgeries, hospitalizations and ER or urgent care visits with dates and reasons
List all your questions /concerns pertaining to your visit
Copies of medical records that are relevant to your visit from your family physician or other specialists - Include hospital records, Office visit notes, lab test results, previous allergy evaluations (skin tests, etc.,) biopsy reports, x-ray, CT or MRI REPORTS (not films or discs) or any other relevant information
Names, phone numbers and fax numbers of doctors you would like us to send consultation and follow up evaluations and from whom we need to get your medical records
Completed all FORMS
Please wear appropriate clothing for ease of physical examination
Please avoid wearing perfumes or strong scented skin and body care products on the day of appointment in the consideration of other allergy sufferers

Medication refills:

Please allow twenty-four hours for routine refills. You can request medication refills 24 hours per day, seven days per week by dialing (650) 556-9577 and leave a msg. The medication refill may be called in the next business day pending physician approval.

For all prescription requests after hours or on weekends, the refill will be called in the next day during business hours, if routine. Some medications are not automatically refilled; so kindly leave your home and work phone numbers. Please leave the name of the drug, the refill number, and the dosage. We DO NOT look up pharmacy phone numbers for you. Please, also leave this information when you call.

For routine refills, the allergist must be seen at least one time within the last 12 months.

Appointments:

We will attempt to confirm your appointment. If you do not get a reminder call the business day before, please call and verify your appointment. Sick patients will be seen, but please contact the office and get a general time you will be seen. Walk-in appointments are welcomed but there may be a slight wait time.

If you cannot keep your appointment, please notify us 24 hours ahead of time. We reserve the right to charge you $100.00 for failed appointments.

Please arrive 30 minutes prior to your appointment.

There will be a $25.00 fee assessed to all returned checks.

A 1.5% per month finance charge will be applied to all late payments.