Ear, Nose & Throat Patient Forms
New patients are asked to complete several important questionnaire forms. This information is required to assure you will receive the best medical care. These forms are available below (Adobe Acrobat format-PDF) to print and complete prior to coming in for your first appointment.
Face Sheet
History Form
HIPAA Form
HIPAA Statement
Insurance Guarantee
Office Policies
Release of Information Form
Allergy Testing Form
Specialist Treatment Waiver
Post-Op Instructions-Septoplasty/Turbinate Reduction
Post-Op Instructions-Sinus
Post-Op Instructions-Tonsillectomy/Adenoidectomy
Post-Op Instructions-Tubes
Chronic Cough Questionnaire
Workers Compensation Information Form
For established patients, we also offer a secure, encrypted patient portal that provides an efficient alternative to phone calls and office visits when you have non-urgent healthcare needs: Request or Cancel Doctor Appointments; Request Medication Refills; Send a Note to Your Provider. Call our office for information on how to activate your account.
