Patient Forms

For New or Returning Patients of Vital Allergy

If you are new patient, please download from the following list of PDFs, print, and complete your registration forms.

Please remember to bring these completed patient forms with you to your appointment.

If you have any problems with the downloads you might also need to download Adobe Acrobat Reader in order to see the forms. If that is the case, please click here to download the Adobe Reader.

Please download and fill out the proper forms to reduce your wait time when you arrive at our office.  If you have any questions on the information requested on the form, or need clarification as to the necessary information we need, please don’t hesitate to call us at (713) 609-1365.  We will be happy to assist you in any way possible.

New Patient Packet

  1. Acknowledgement of Missed Appointments Consent
  2. New Patient Demographics (Part 1)
  3. New Patient Demographics (Part 2)
  4. New Patient Financial Policy
  5. Consent to Release Information
  6. Privacy Practices Acknowledgement

Financial Policy Packet

  1. VAAC Financial Policy (Part 1)
  2. VAAC Financial Policy (Part 2)
  3. VAAC Financial Policy (Part 3)
  4. VAAC Financial Policy (Part 4)

Have Questions About These Forms?

Give us a call at (713) 609-1365. We’re happy to help.

ALLERGY / ASTHMA / ACNE

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Vital Allergy & Asthma Center specializes in the comprehensive treatment of Allergies, Asthma and Acne conditions

Vital Allergy & Asthma Center

Vital Allergy & Asthma Center