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Allergy Referral Guidelines
Request referral pads
Outpatient Appointment Referral Pads (PDFs)
Northern Virginia - 2020: English | En Español
Maryland - 2020: English | En Español
Montgomery County Imaging - 2020: English
Additional Requirements for Allergy Referrals
The following information must be included on all referrals:
- Office Visit/Consultation
Choose one or more of the following:
- Allergy skin testing
- Allergy immunotherapy
- Replacement of allergy vaccines
- Pulmonary function testing
- Serum immunoglobulins and specific antibodies, allergy panel
- Teaching (environmental control, inhalation therapy, peak flow meter)
Patients should bring results of previous testing and chest radiographs, when appropriate.
Patients should receive no antihistamine for five days before first appointment, if possible.