Get Allergy Form

Completing the Allergy Form online is an essential step for receiving allergy injections at the John C. Longest Student Health Center. This guide will provide you with a clear, step-by-step approach to filling out the form accurately and efficiently.

Follow the steps to complete your Allergy Form online.

1. Click ‘Get Form’ button to obtain the Allergy Form and open it in your preferred online editor or form-filling tool.
2. Fill in your name in the designated field labeled 'Patient Name.' Ensure that you enter your full legal name for proper identification.
3. Enter your Social Security Number in the appropriate field. This information is used for administrative identification purposes.
4. Provide your date of birth in the requested format. This will help confirm your eligibility for treatment.
5. In the section where you authorize the physicians, write your name again as the patient. This indicates your consent for the treatment.
6. Review the explanation of the procedure thoroughly. Ensure you understand the potential risks associated with allergy vaccine injections.
7. Sign and date the form in the designated area for the patient signature. This step confirms your consent for the procedure.
8. Find the witness signature fields. A third party should sign and date the form in these areas to validate your consent.
9. After completing all sections of the form, you can save your changes, download the finished document, print it, or share it as needed.

Take the next step in your health journey by completing the Allergy Form online today.