Immunotherapy Consent and Instruction Forms

By accepting the Terms of Use, you agree that these forms are being provided for educational and informational purposes only and are not intended to be a substitute for your independent medical judgment. The AAAAI is not liable for any decision made, or action taken by you or anyone else, in reliance upon the information contained within these forms.

As a members-only benefit, the forms can be edited and customized for individual practices.

5a Allergen immunotherapy Patient Consent Form (Word)
5a Allergen immunotherapy Patient Consent Form (PDF)

5b Immunotherapy Background Info for Patients (Word)
5b Immunotherapy Background Info for Patients (PDF)

5c Letter to Supervising Physician (Word)
5c Letter to Supervising Physician (PDF)

5d Instruction and Consent Letter for Patients (Word)
5d Instruction and Consent Letter for Patients (PDF)

5e What Is Allergen Immunotherapy (Word)
5e What Is Allergen Immunotherapy (PDF)

5x Spanish Immunotherapy Background Information for Patients (Word)
5x Spanish Immunotherapy Background Information for Patients (PDF)

5y Spanish Allergen immunotherapy Patient Consent Form (Word)
5y Spanish Allergen Immunotherapy Patient Consent Form (PDF)

5z Spanish Instruction and Consent Letter for Patients (Word)
5z Spanish Instruction and Consent Letter for Patients (PDF)

12/3/2024