Allergy Scheduling Information

Allergy Online
Appointment Request

Please complete this form to submit your appointment request. The information is submitted securely to our office.

We respond to all requests within 48 hours but strive to respond within 24 hours. Do not submit this form for medical emergencies. For emergencies please dial 911 or immediately contact your medical provider by phone.

Name
Email
Phone
Date of Birth
Name of Insurance
Preferred Location
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Additional Information

Abner Bagenstose, MD
Scott Bagenstose, MD
Mehmet Basaran, MD
Roger Friedman, MD
Erica Glancy, MD
Megan Goebel, MD
David Hauswirth, MD

Columbus
974 Bethel Road, Entrance C, Columbus, OH 43214
(614) 459-4949 / Fax (614) 459-4951 *Drs. Bagenstose
(614) 891-0550 / Fax (614) 891-0429 *Drs. Hauswirth and Glancy

Gahanna
1110 Beecher Crossing N., Suite C, Gahanna, OH 43230
(614) 933-0312 / Fax (614) 933-8903

Westerville
477 Cooper Road, Suite 480, Westerville, Ohio 43081
(614) 891-0550 / Fax (614) 891-0429

Dublin
6670 Perimeter Drive, Suite 270, Dublin, OH 43016
(614) 891-0550 / Fax (614) 891-0429

Delaware
801 OhioHealth Blvd., Suite 220, Delaware, OH 43015
(614) 891-0550 / Fax (614) 891-0429