Patient Forms

We appreciate you taking the time to print and fill out the required medical forms listed below prior to your first visit to Saint Clair Allergy and Asthma, PLLC.

Please click the following links to download and print each form:

Authorization to Obtain Medication History

SCAAC Records Release

SCAAC Notice of Privacy Practices

SCAAC Patient Information Form

SCAAC Information Acknowledgement & Consent Form

Patient Medical History Form

Medical Records

Please obtain any medical records which may be helpful in your care and reduce redundancy. This includes any recent:

  • Skin Test Results 
  • Laboratory Reports 
  • Sinus or Head CT Reports and/or CD 
  • Pulmonary Function Tests 
  • Chest x-rays or CT scans 





Shelby Township

50505 Schoenherr Road
Suite 350
Shelby Twp., MI 48315
Phone: 586-884-5656
Fax: 586-884-5674

St. Clair Shores

25200 Little Mack Ave.
St. Clair Shores, MI 48081
Phone: 586-884-5656
Fax: 586-884-5674

Office News


 September 10, 2018
**New/Extended Shot Hours Begin**

Office Closures

Holiday Office Closures:

November 22, 2018
Thanksgiving Day

December 24 & 25, 2018
Christmas Eve & Christmas Day

December 31, 2018
New Year's Eve 

January 1, 2019
New Year's Day




Dr. White's Words