YOUR FIRST VISIT:

 

Download our Preparation Packet This simple document gives you everything you need to make your new patient visit easy. It includes directions to our locations, phone numbers and a new patient registration form. Bring the completed packet with you to the appointment so we can expedite the patient registration process.

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Please arrive 15 minutes before your appointment time if you have completed your paperwork, or 30 minutes before if you have not. The purpose of this visit is to obtain a detailed history of your problem and to do a physical examination. If skin testing is to be done that will also begin on this visit. Allow at least 1 1/2 -2 hours for this appointment.

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PLEASE DO NOT TAKE ANTIHISTAMINES 4 DAYS PRIOR TO THIS VISIT

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Antihistamines interfere with the interpretation of allergy testing. Afrin Nasal Spray, Alavert, Allegra (fexofenadine HCL), Allegra D (fexofenadine w/ pseudo), Astelin Nasal Spray, Atarax (hydroxyzine), Benadryl (diphenhydramine), Bilastine, Bromfed, Clarinex (desloratadine), Claritin (loratadine), Claritin D (loratadine w/ pseudo), Chlortrimeton, Dimetapp, Doxepin, Dry-lex, Extendryl Jr. Sr. or chewable, Neo-synephrine Nasal Spray, Nolamine, PBZ, PCM chewables, Palgic, Periactin, Rondec, Ryna 12, Rynatan, Tavist, Tavist D, Triaminic (chlorpheniramine), Zyrtec (cetirizine HCL), Xyzal. ANY OTC cough/cold combination medication or allergy medication ie: (Advil Allergy Sinus, Actifed, Drixoral, Pediacare cough/cold, Thera-Flu cough/cold, Robitussin cough/cold etc.) Please do not stop any other medications that have been prescribed for you.

 

SINGULAIR and PLAIN SUDAFED are not antihistamines.

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Please call your pharmacist if you have any questions regarding this.

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What to bring to your first appointment:
 

• A complete list of medications you are taking, with dose and frequency records from other physicians.
   

• Previous allergy treatment, x-rays, labs, or pulmonary function tests that you think may be helpful.
   

• Pertinent records from other physicians
   

• A list of any known drug allergies.
   

• Questions to ask your doctor.
   

• Your insurance card and co-payment for the visit.
   

 

Medical Release Form

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Financial Information:

The following information is provided to all patients to avoid any misunderstanding or disagreement concerning payment for professional services. If you have questions regarding your insurance coverage or need for referrals, please call your insurance company. If you have any questions regarding this financial information, please call our billing office at 603-436-7897 option #3 or you can email Jen at jen@allergynh.com . 

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For your convenience we will bill your insurance company directly for professional services provided to you. As a courtesy to you, we will also bill any secondary insurance coverage that you have. We cannot submit claims to insurance companies outside of the United States. We are not providers for Maine Medicaid.

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Depending on the insurance company, type of policy, and the benefits provided, you may be responsible for co-payments, co-insurance or deductible amounts.  It is your responsibility to verify your insurance benefits and network participation.  Co-payments are due at the time of your visit.  We accept cash, check, Mastercard, Visa and Discover.  We will send you and itemized statement for amounts applied to co-insurance, deductible and amounts not covered by your insurance.  All statements are due and payable upon receipt.  Please note that your insurance coverage is an agreement between you and your insurance company, it is your responsibility to remit payment for charges not covered by your insurance company.

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If your insurance company requires a referral from your primary care physician please have the referral sent to us or have it with you at your appointment. You will be responsible for payment on any claims denied by your insurance if no referral was obtained or the referral is invalid.

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We reserve the right to bill for appointments not canceled 24 hours prior to the visit.