Add an allergy service line to your practice

Add allergy testing and immunotherapy to your practice — a new revenue line from the patients you already see, set up and managed by ACE Allergy. No upfront cost. Complete your practice profile below and we'll be in touch. Fields marked * are required.

Clinic information

Practice name *

Practice phone *

Practice fax *

Street address *

City *

State *

ZIP *

Desired start date *

Contact

Contact person *

Contact phone *

Contact email *

Physicians & providers

Up to three prescribers. The first becomes the clinic's primary provider; all are kept on the practice profile.

Prescriber 1 (primary)

First name *

Last name *

NPI # *

License # *

Email *

Cell phone *

Prescriber 2

First name

Last name

NPI #

License #

Cell phone

Prescriber 3

First name

Last name

NPI #

License #

Cell phone

Billing contact

Billing manager name *

Billing phone *

Billing email *

Office demographics

Practice specialty (their own) *

Patients seen per week *

# prescribers on site *

Patients/week likely to order immunotherapy *

Office days & hours *

More than one prescriber will use the service

Top insurance plans (by % of practice)

Sends your details to the ACE team for review.

Altus ACE Management LLC