Please download the clinic forms based on the patient age. Pediatric if less than 18 years, adult if 18 years or older. Answer ALL questions even if you feel they are not pertinent to your problem or concern.

Adult Patient Questionnaire (over 18)
Pediatric Patient Questionnaire (under 18)
HIPAA Privacy Form
Evaluation Questionnaire

 

If you have asthma or think that you might have asthma, you can practice this test. This is might give you an idea if you or your child have a risk of asthma or your asthma is not under control.

Please fill out one of these forms based on your age (we will be very happy to help you analyse the results of this test free of charge if mailed or faxed to us):

Asthma Control Test (4-11 years)
Asthma Control Test (age 12 and older)
Asthma Life Quality test. (all ages)
Asthma Screening Test (age 1-7 years)
Asthma Screeniing Test (age 8-14 years)

We highly value your opinion and we will do our best to meet and exceed your expectations. We really appreciate your honest evaluation and it will help us improve our service to you and to all other patients.

Please download the evaluation form and either e-mail it to Dr. George Allen's PERSONAL e-mail at (georgeallen69@gmail.com) OR mail it to Dr. George Allen's PERSONAL mail box address: P.O Box 821046. Vancouver, WA 98682. Thank you for your time.

Evaluation Questionnaire