Patient Forms

New Patients

If skin testing is likely, please review list of medications to discontinue prior to your skin testing appointment.

• List of Medications to Discontinue Before Skin Testing

School and Daycare Forms

• School Medication Form
• Food Allergy Action Plan Form

*Please download and fill out patient information sections. Upload via the patient portal or fax to the appropriate office below for the nurse/physician to complete. Please be sure to specify the brand of epinephrine the patient is currently using.

Ann Arbor/Canton/Chelsea – Fax: (734) 434-6212

Novi/Brighton – Fax: (248) 349-3778

Bingham Farms/Livonia – Fax: (248) 932-0182

NEW SCHOOL FORM POLICY FOR 2026:

Due to the high volume of urgent requests in the days before the school year begins, we will be implementing a new school forms policy for 2026. School forms will be available within 10 business days of the request (up to 2 calendar weeks). If you require expedited forms, they will be available at the end of the next business day for a fee. Thank you for your understanding so that we may better schedule our staff and continue to provide timely, comprehensive care.

Medical Records Release Form:

We store patient records for up to seven years after the patient's last visit. If you need to obtain your records, please download and fill out this form. It can be emailed to info@annarborallergy.com or faxed to 734-434-6212.  Please allow up to 10 business days for record request completion.

• Medical Record Release Form

Allergy & Immunology Associates of Michigan’s medical records fee is in accordance with the Medical Records Access Act, Public Act 47 of 2004, MCL section 333.26269. The Department of Health and Human Service sets the rate health care providers may charge for copies of records. Please be advised there may be a charge for copies of medical records and additional requests to other physicians.