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Asthma, Allergy Care
Center of Florida
Dr. Shahnaz Fatteh, M.D.
Board Certified, Allergy & Immunology
CONTACT US TODAY
Please Call (954) 723-0334
Fax: (954) 278-8000
*Please fill out all necessary forms in the attached intake packet above and bring them to your first appointment along with your ID and insurance card.
NEW PATIENT DOCUMENT CHECK LIST
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PICTURE ID
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INSURANCE CARD
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MEDICATION LIST
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REFERRAL FROM PCP
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AUTORIZATION FROM PCP (IF YOU HAVE A MEDICAID OR MEDICARE HMO)
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ALLERGY LIST
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