New Patient Forms
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Antigen Refill Request
Patient's Name (if different than above):
Antigen Refill Needed
Pollen, Dust, Mold (PDM)
Look on the current bottle that you need a refill of -- it will say what is in it. If you have any questions please call our office.You will need to call to schedule a shot/drops appointment if you are doing your build up at our office, or, if you are on maintenance and normallyget your first shot/drops out of the bottle with us.