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Award Winning Food Allergist Dr. Atul Shah and our team have been helping Food Allergy Families for 20+ years. We have 15,000+ Success Stories and are excited to help you on your path to Food Allergy Freedom. Schedule an appointment by filling out the form below or give us a call today!

212-301-7636

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PROGRAM OVERVIEW

Understanding Insurance at NYFA

Please note, while our Long Island and Manhattan offices accept insurance, it DOES NOT cover exclusive 1-on-1 care with Dr. Shah. Insurance-based visits still provide excellent support with Dr. Shah's guidance; however, opting for private care allows you exclusive access to his full attention and expertise.

NEW PATIENT FORM

Parent/Guardian Name

First Name

Last Name

Patient First & Last Name

First Name

Last Name

Patient Date of Birth

Patient Gender

Phone

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How did you hear about us?

Food Allergy Summary

Include history and concerns, foods, types of reactions, prior skin tests, blood tests, component tests, BAT, prior food challenges, prior OIT/SLIT/Patch)

Purpose of the Consultation

Comprehensive Diagnosis

Skin Tests

Blood Tests

Component Tests

Basophil Activation Test

Oral Food Challenges

Long Term Food Allergy Freedom Plan

List desired long term food allergy freedom goals and interests.

For Example: Protection against accidental reactions, bite-proof freedom, Free-eating) 1. Food Oral Challenges 2. Food SLIT (Sublingual Immunotherapy) 3. Food OIT (Oral Immunotherapy) 4. Biologics + OIT 5. Combination of 1, 2, 3, 4

Other Needs - Please List

Food related anxiety, FPIES, EoE, Gluten Sensitivity, Lactose Intolerance, Fresh fruit - pollen allergy, Alpha-gal Red Meat Allergy, Seasonal Allergy, Asthma, Eczema

How soon do you want to be seen?

(List days and times preferred based on your availability)

Park Sixty Medical
110 East 60th Street, Suite 708
New York, NY 10022

212-301-7636