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img 108 John Robert Thomas Dr. Exton, PA 19341
New Patient Registration and History Forms

New patient registration forms are a vital part of your visit to our office. They allow us to make your visit as fast and effective as possible. We request that you submit your forms as soon as possible, preferably 2 weeks prior to your visit, in order for us to organize your file.

To submit your forms online click the “New Patients Registration and History Form” below.  After you submit the registration form click on the “New Patient History Form.”  You are required to fill out both forms before visiting our office.




If you prefer that we send you the registration forms in the mail or by fax please call the office. Fill the forms and either:

Fax to: (610) 363-8097  Tel: (610) 363-0907

Or mail to:

Dr. M. K. Effat

Allergy and Asthma Center.

108 John Robert Thomas Drive.

Exton PA, 19341


All paperwork MUST  be returned by mail or fax as soon as possible or at least 3 days prior to the appointment to avoid delay during the visit.