Patient Forms
There are certain new patient forms that everyone needs to fill out as soon as they show up for their appointment. For your convenience, and to save you time when visiting us, we've posted all of the forms we'll need from you. Follow the instructions below to download, print and send each form.
New Patient Information PDF.pdf
click to download
New Patient Info Form.pdf
click to download
Waiver & Release.pdf
click to download
Privacy Notice.pdf
click to download
Receipt of Privacy Notice 2016_1.pdf
click to download

Click on any of the forms above and to download them onto your computer.

Once you download the forms, you can either fill out the forms using the Adobe program or print out the forms to fill out by hand. We will accept these forms via snail mail, email or in person.

If you wish to email us your forms once they are filled out, you can send them to us at

If you're interested in mailing the forms to us, make sure your appointment has been scheduled far enough out to give the postal service time to deliver. You can mail the forms to:

Advanced Allergy Relief of Kansas
2456 N. Woodlawn
Wichita, KS 67220